Roy适应模式护理在行腹腔镜胰十二指肠切除术患者中的应用效果

Application effect of nursing of Roy adaptation model in patients undergoing laparoscopic pancreaticoduodenectomy

目的考察Roy适应模式护理在行腹腔镜胰十二指肠切除术患者中的应用效果。方法回顾性分析2018年1月至2021年1月在徐州医科大学附属医院接受腹腔镜胰十二指肠切除术治疗的80例患者的资料,根据护理方法的不同分为对照组(40例)和观察组(40例)。对照组给予优质护理,观察组给予Roy适应模式护理。比较2组的术中指标、术后胃肠道功能恢复情况、心理状态、疼痛程度、营养状况和术后并发症发生情况(腹腔感染、胃排空障碍、出血、胆瘘和胰瘘)。结果观察组的术后肠鸣音恢复时间、首次排便及排气时间均早于对照组,住院时间短于对照组(P均<0.05),术中出血量和手术时间与对照组比较,差异均无统计学意义(P均>0.05)。术后3 d,2组的焦虑、抑郁情绪评分均低于术前(P均<0.05),视觉模拟评分法(VAS)评分均低于术后1 d(P均<0.05);观察组的焦虑、抑郁情绪评分和VAS评分均低于对照组(P均<0.05)。术后3 d,2组的营养指标(血红蛋白、总蛋白和白蛋白)均低于术前(P均<0.05),但观察组的血红蛋白、总蛋白和白蛋白水平均高于对照组(P均<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。结论Roy适应模式护理可有效改善行腹腔镜胰十二指肠切除术患者的心理状态和营养状况,促进术后胃肠道功能的恢复,降低并发症发生率,缩短住院时间。

Objective To investigate the application effect of nursing of Roy adaptation model in patients undergoing laparoscopic pancreaticoduodenectomy.Methods The data of 80 patients who underwent laparoscopic pancreaticoduodenectomy at the Affiliated Hospital of Xuzhou Medical University from January 2018 to January 2021 were retrospectively analyzed.According to the nursing methods,they were divided into a control group(40 cases)and an observation group(40 cases).The control group was given high-quality nursing,and the observation group was given nursing of Roy adaptation model.The intraoperative indicators,postoperative gastrointestinal function recovery,psychological status,pain intensity,nutritional status,and postoperative complications(abdominal infection,delayed gastric emptying,bleeding,biliary fistula,and pancreatic fistula)were compared between the two groups.Results The postoperative bowel sound recovery time,first defecation time,first exhaust time,and hospitalization time of the observation group were shorter than those of the control group(all P<0.05).There were no significant differences in the intraoperative blood loss and operating time between the two groups(both P>0.05).On the 3rd day after operation,the anxiety and depression scores of the two groups were lower than those before operation(all P<0.05),and the Visual Analogue Scale(VAS)scores were lower than those on the 1st day after operation(all P<0.05).The scores of anxiety,depression,and VAS of the observation group were lower than those of the control group(all P<0.05).On the 3rd day after operation,the nutritional indicators(hemoglobin,total protein,and albumin)of the two groups were lower than those before operation(all P<0.05),but the levels of hemoglobin,total protein,and albumin in the observation group were higher than those in the control group(all P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion Nursing of Roy adaptation model can effectively improve the psychological status and nutritional status of patients undergoing laparoscopic pancreaticoduodenectomy,promote the recovery of postoperative gastrointestinal function,reduce the incidence of complications,and shorten the hospitalization time.