手术室与病房衔接护理对腹腔镜下肾癌根治性肾切除术患者应激反应及舒适度的影响

Effects of intermediate nursing between operating room and ward on stress response and comfort level in patients undergoing laparoscopic radical nephrectomy for renal cancer

目的探讨手术室护理与病房护理相衔接护理对行腹腔镜下根治性肾切除术肾癌患者应激反应及舒适度的影响。方法选取2019年4月至2021年5月间空军军医大学第二附属医院收治的98例行腹腔镜下根治性肾切除术肾癌患者为研究对象,采用随机数表法分为试验组和对照组,每组49例。对照组采用常规护理,试验组采用手术室护理与病房护理相衔接护理。比较两组心理状态、应激反应、舒适度及视觉模拟评分(VAS)的差异。结果术前1d,两组焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分比较,差异无统计学意义(P>0.05)。出院时,两组上述评分均下降但是试验组降幅大于对照组,且评分低于对照组,差异均有统计学意义(均P<0.05)。术前1d,两组生理应激指标比较,差异无统计学意义(P>0.05)。术后3d,两组C反应蛋白(CRP)、白介素-6(IL-6)及血清皮质醇(Cor)均上升,但试验组仍低于对照组,差异均有统计学意义(均P<0.05)。术后2h,两组VAS评分比较,差异无统计学意义(P>0.05)。术后12h、术后24h、术后72h,两组VAS评分均呈下降趋势,但试验组较对照组降幅大且显著低于对照组,差异均有统计学意义(均P<0.05)。试验组各项舒适度评分均高于对照组,差异有统计学意义(P<0.05)。结论对行腹腔镜下根治性肾切除术肾癌患者采取手术室护理与病房护理相衔接护理,可以有效改善应激反应,提高舒适度,减少疼痛。

Objective To explore the effects of the intermediate nursing between operating room and ward on the stress response and comfort in renal cancer patients undergoing laparoscopic radical nephrectomy.Methods A total of 98 kidney cancer patients undergoing laparoscopic radical nephrectomy at Second Affiliated Hospital of Force Military Medical University were selected from April 2019 to May 2021.Using the random number table method,they were divided into an experimental group and a control group with 49 patients each.The experimental group adopted intermediate nursing in the operating room and the ward and the control group received routine nursing.The differences in stress response,comfort and visual analogue scale(VAS)scores were compared between the two groups.Results At 1 d before the operation,there was no significant difference in self-rating anxiety scale(SAS)and self-rating depression scale(SDS)between the two groups(P>0.05).On discharge,the above scores decreased in the two groups and the decrease was greater in the experimental group than in the control group,and the score was lower than in the control group(all P<0.05).At 1 d before the operation,there was no significant difference in physiological stress indicators between the two groups(P>0.05).At 1 d before the operation,C-reactive protein(CRP),interleukin-6(IL-6),and cortisol(Cor)increased in the two groups(P>0.05)and the levels were lower in the experimental group than in the control group(all P<0.05).At 2 h postoperatively,there was no significant difference in VAS scores between the two groups(P>0.05).However,the VAS scores of the two groups showed a downward trend at 12 h,24 h,and 72 h after surgery,and the experimental group had a larger decline than the control group and that was significantly lower than in the control group(all P<0.05).The comfort level was significantly higher in the experimental group than in the control group(all P<0.05).Conclusion For patients with renal cancer undergoing laparoscopic radical nephrectomy,the intermediate nursing in operating room and ward can effectively improve stress response,improve comfort,and reduce pain.