多维度护理联合术后早期活动对腹腔镜肝癌切除术患者预后的影响

Effect of multi-dimensional nursing combined with early postoperative activity on the prognosis of patients undergoing laparoscopic liver resection

目的探讨多维度护理及术后早期活动对行腹腔镜肝癌切除术患者术后心理状态、应激反应、胃肠功能水平和恢复时间及住院时间的影响。方法收集2019年2月—2021年8月医院行腹腔镜肝癌切除术治疗的患者256例作为观察对象,按照组间基本特征均衡可比的原则分为对照组和观察组,各128例。对照组予以常规护理,观察组开展多维度护理及术后早期活动干预,对比两组的心理状态、应激反应、胃肠功能指标及住院时间。结果观察组护理后心理弹性量表简化版评分比对照组高,恐惧疾病进展简化量表评分比对照组低,组间比较差异具有统计学意义(P<0.05);观察组术后24 h的促肾上腺皮质激素、皮质醇、醛固酮水平比对照组低,组间比较差异具有统计学意义(P<0.05);观察组术后3 d时的胃动素、血清胃泌素水平比对照组高,血管活性肠肽水平比对照组低,组间比较差异具有统计学意义(P<0.05);观察组的肠鸣音恢复、肛门排气、首次进食、肛门排便及住院时间均短于对照组,组间比较差异具有统计学意义(P<0.05)。结论多维度护理及术后早期活动可有效改善腹腔镜肝癌切除术患者心理状态,减轻应激反应,并且有助于促进胃肠功能恢复。

Objective To explore the effects of multi-dimensional nursing and early postoperative activities on postoperative psychological state,stress response,gastrointestinal function,recovery time and hospitalization time in patients undergoing laparoscopic liver resection.Methods A total of 256 patients who underwent laparoscopic hepatectomy in the hospital from February 2019 to August 2021 were collected as observational objects,and they were divided into a control group and an observation group according to the principle of balance and comparability of basic characteristics between groups,with 128 cases in each group.The control group received routine nursing care,while the observation group received multi-dimensional nursing care and early postoperative activity intervention,and the psychological state,stress response,gastrointestinal function indexes and hospitalization time were compared between the two groups.Results The scores of the simplifi ed version of the psychological resilience scale after nursing in the observation group were higher than those in the control group,the fear of progression questionnaire-short form score was lower than that in the control group,and the diff erences between the groups were statistically signifi cant(P<0.05).The levels of adrenocorticotropic hormone,cortisol and aldosterone in the observation group at 24 hours after operation were lower than those in the control group,and the diff erences between the groups were statistically signifi cant(P<0.05).The levels of motilin and serum gastrin in the observation group were higher than those in the control group,the level of vasoactive intestinal peptide was lower than that in the control group at 3 days after operation,and the diff erences between the groups were statistically signifi cant(P<0.05).The recovery of bowel sounds,anal exhaust,fi rst eating,anal defecation and hospitalization time in the observation group were shorter than those in the control group,and the diff erences between the groups were statistically signifi cant(P<0.05).Conclusion Multi-dimensional nursing and early postoperative activities can eff ectively improve the psychological state of patients undergoing laparoscopic liver resection,reduce stress response,and help to promote the recovery of gastrointestinal function.