术后早期活动护理干预在肝癌肝叶切除患者中的应用效果

Application effect of early postoperative activity nursing in patients undergoing hepatectomy for liver cancer

目的探究行肝叶切除术的肝癌患者应用术后早期活动护理干预的效果,评估其对术后并发症发生率、日常生活能力所产生的影响。方法对2021年1~12月于山东大学齐鲁医院接受肝叶切除术治疗的90例肝癌患者的临床资料进行回顾性分析,将纳入对象按护理措施的不同划分为2组。对照组(46例)采取常规围手术期护理,观察组(44例)基于常规围手术期护理采取术后早期活动护理干预。比较2组患者的术后恢复指标、日常生活能力、肝功能指标及并发症发生率。结果观察组的肛门首次排气时间、首次排便时间、肠鸣音恢复时间及引流管拔除时间均较对照组更早,术后并发症总发生率较对照组更低(P均<0.05)。相较于术前,2组在术后1 d、术后3 d及出院前的日常生活能力量表(ADL)评分均升高(P均<0.05);相较于同期对照组,观察组的ADL评分均更高(P均<0.05)。与术前相比,2组在术后1 d及出院前的血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和总胆红素(TBIL)水平均有所改善(P均<0.05);与同期对照组相比,观察组均更优(P均<0.05)。结论对行肝叶切除术的肝癌患者实施术后早期活动护理干预,在促进术后康复、提升日常生活能力及改善肝功能方面均具有积极意义,并可有效预防并发症的发生。

Objective To explore the effect of nursing intervention of early postoperative activity on the patients undergoing hepatectomy for liver cancer,and to evaluate its impact on the incidence of postoperative complications and activities of daily living.Methods The clinical data of 90 liver cancer patients who received hepatectomy at Qilu Hospital of Shandong University from January to December 2021 were analyzed retrospectively.They were divided into two group according to different nursing measures.The control group(46 cases)received routine perioperative nursing,while the observation group(44 cases)received early postoperative activity nursing based on the routine perioperative nursing.The postoperative recovery indicators,activities of daily living,liver function indicators,and incidence of complications were compared between the two groups.Results Compared with the control group,the observation group had shorter time of first anal exhaust,first defecation,bowel sound recovery,and drainage tube removal,and lower incidence of postoperative complications(all P<0.05).On the 1st and 3rd day after operation and before discharge,the scores of Activity of Daily Living Scale(ADL)in the two groups were higher than those before operation(all P<0.05),and the observation group had higher ADL scores than the control group(all P<0.05).On the 1st day after operation and before discharge,the levels of serum aspartate aminotransferase(AST),alanine aminotransferase(ALT),and total bilirubin(TBIL)in the two groups were improved when compared with those before operation(all P<0.05),and the observation group was superior to the control group(all P<0.05).Conclusion The nursing intervention of early postoperative activity is of positive significance in promoting the postoperative rehabilitation,enhancing the activities of daily living,and improving the liver function of patients undergoing hepatectomy for liver cancer,and can effectively prevent the complications.