快速康复外科理念在结直肠癌合并糖尿病患者围术期护理中的应用研究

Application of Fast Recovery Surgery Concept in Perioperative Nursing of Colorectal Cancer Patients with Diabetes Mellitus

目的 探讨结直肠癌(colorectal cancer,CRC)合并糖尿病(diabetes mellitus,DM)患者应用快速康复外科(fast-track surgery,FTS)理念实施围术期护理取得的效果。方法 选取2020年5月—2021年8月福建医科大学附属南平第一医院收治的98例CRC合并DM患者作为研究对象,以随机数表法将其分为对照组(49例)与研究组(49例)。两组均实施CRC根治术,对照组采取常规围术期护理措施,研究组采用FTS理念实施围术期护理。比较两组首次进食时间、肛门排气时间、首次离床活动时间、住院时间,术前与术后第3天的血糖水平,以及并发症发生率。结果 研究组术后首次进食、肛门排气、离床活动时间及住院时间相较于对照组更短,差异有统计学意义(P<0.05)。两组术前FPG与2 hPG水平比较,差异无统计学意义(P>0.05);术后第3天,研究组FPG与2 hPG水平较对照组低,差异有统计学意义(P<0.05)。研究组并发症发生率(4.08%)低于对照组(18.37%),差异有统计学意义(χ~2=5.018,P<0.05)。结论 CRC合并DM的患者应用FTS理念实施围术期护理能够有效加快康复进程,维持血糖的稳定性,降低并发症发生率,具有临床应用与推广价值。

Objective To investigate the effect of fast-track surgery(FTS) concept in perioperative nursing for colorectal cancer(CRC) patients with diabetes mellitus(DM).Methods A total of 98 CRC patients with DM who were admitted to Nanping First Hospital Affiliated to Fujian Medical University from May 2020 to August 2021 were selected as the research subjects.They were divided into control group(49 cases) and study group(49 cases) by random number table method.Both groups underwent CRC radical resection.The control group adopted routine perioperative nursing measures,while the study group adopted the concept of FTS to implement perioperative nursing.The time of eating,the time of anal exhaust,the time of first getting out of bed,the length of hospital stay,the blood glucose level before surgery and on the 3rd day after surgery,and the incidence of complications were compared between the two groups.Results Compared with the control group,the time of first eating,anal exhaust,getting out of bed,and hospital stay in the study group were shorter than those in the control group,and the differences were statistically significant(P0.05);On the 3rd day after operation,the levels of FPG and 2 hPG in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the study group(4.08%) was lower than that in the control group(18.37%),and the difference was statistically significant(χ~2=5.018,P<0.05).Conclusion The application of FTS concept to implement perioperative nursing in CRC patients with DM can effectively speed up the recovery process,maintain the stability of blood glucose,and reduce the incidence of complications,which has clinical application and promotion value.