基于优化理念的干预模式在肾癌根治术患者围手术期中的应用效果

Application effect of intervention mode based on optimization concept in the perioperative period of patients undergoing radical nephrectomy for renal cancer

目的探讨基于优化理念的干预模式在肾癌根治术患者围手术期中的应用效果。方法将2018年1月至2019年9月围手术期实施常规干预的59例肾癌患者作为对照组,将2019年10月至2021年6月围手术期实施优化理念干预模式的66例肾癌患者作为观察组。比较两组患者的手术相关指标、依从性[Morisky服药依从性量表(MMAS)]、心理状况[焦虑自评量表(SAS)和抑郁自评量表(SDS)]、疼痛程度[视觉模拟评分法(VAS)]及并发症发生情况。结果观察组患者肛门排气时间、首次下床活动时间、住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者依从性均优于本组干预前,且观察组患者的依从性优于对照组,差异有统计学意义(P﹤0.05)。干预后,两组患者SAS、SDS、VAS评分均低于本组干预前,观察组患者SAS、SDS、VAS评分均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的并发症总发生率为3.03%,明显低于对照组患者的15.25%,差异有统计学意义(P﹤0.01)。结论基于优化理念的干预模式在肾癌根治术患者围手术期中的应用效果较好,可促进患者的术后恢复,改善负性情绪,降低并发症发生率。

Objective To analyze the application effect of intervention mode based on optimization concept in the perioperative period of patients undergoing radical nephrectomy for renal cancer.Method A total of 59 patients with renal cancer who received perioperative routine intervention from January 2018 to September 2019 were collected as the control group,and 66 patients with renal cancer who received perioperative intervention mode based on optimization concept from October 2019 to June 2021 were collected as the observation group.Surgical indicators,adherence[Morisky medication adherence scale(MMAS)],psychological status[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)],pain degree[visual analogue scale(VAS)]and complications were compared between the two groups.Result The anal exhaust time,the first ambulation time and the length of hospital stay in the observation group were significantly shorter than those in the control group(P<0.01).After intervention,the adherence of both groups were significantly improved,with better adherence in observation group than that in the control group(P<0.05).After intervention,the scores of SAS,SDS and VAS were decreased,with lower scores in the observation group than those in the control group(P<0.05).The total incidence of complications in the observation group was 3.03%,significantly lower than 15.25% in the control group(P<0.01).Conclusion The intervention mode based on optimization concept has good effect in perioperative period of patients undergoing radical nephrectomy,which can promote patients’recovery,improve negative mood,and reduce the incidence of complications.