快速康复理念在结直肠癌围术期的应用对患者术后胃肠功能恢复及应激反应的影响

Effect of Rapid Rehabilitation Concept on Postoperative Gastrointestinal Function Recovery and Stress Response in Patients with Colorectal Cancer During Perioperative Period

目的:探讨快速康复理念在结直肠癌围术期的应用对患者术后胃肠功能恢复及应激反应的影响。方法:将2022年5月至2023年2月于我科拟接受手术治疗的90例结直肠癌患者作为研究对象,根据随机数字表法分为观察组和对照组,各45例。对照组围术期接受常规护理干预,观察组接受快速康复理念护理干预。比较2组患者术后胃肠功能恢复情况、应激反应指标[血清皮质醇(Cor)、C-反应蛋白(CRP)、白介素-2(IL-2)]、术后并发症发生情况、情绪状态[汉密尔顿焦虑评分表(HAMA)评分、汉密尔顿抑郁评分表(HAMD)评分]。结果:观察组患者术后首次排气时间、最早进食时间、首次排便时间均比对照组早(P<0.05)。术前一天,2组Cor、CRP、IL-2水平比较差异无统计学意义(P>0.05);术后第1天,2组Cor、CRP、IL-2水平均升高,观察组升高幅度均小于对照组(P<0.05)。观察组术后并发症总发生率低于对照组(P<0.05)。干预前,2组患者HAMD、HAMA评分比较差异无统计学意义(P>0.05);干预后,2组HAMD、HAMA评分均降低,但观察组低于对照组(P<0.05)。结论:结直肠癌围术期基于快速康复理念进行护理干预可促进胃肠功能恢复,减轻机体应激反应,降低术后并发症发生率,减轻患者焦虑、抑郁情绪。

Objective To investigate the effect of the application of rapid rehabilitation concept on post-operative gastrointestinal function recovery and stress response in the perioperative period of colorectal cancer.Methods Total 9o patients with colorectal cancer who were to receive surgical treatment in our department from May 2022 to February 2023 were selected as research objects and divided into observation group and control group according to random number table method,45 cases in each group.The control group received routine nursing intervention during perioperative period,and the observation group received nursing intervention with rapid rehabilitation concept.Postoperative gastrointestinal function recovery,stress response indexes[serum cortisol(Cor),C-reactive protein(CRP),interleukin-2(IL-2)],postoper-ative complications,and emotional state[Hamilton Anxiety Scale(HAMA)score,Hamilton Depression Scale(HAMD)scoreJ of the two groups were compared.Results The first exhaust time,the earliest feeding time and the first defecation time in the observation group were earlier than those in the control group(P<0.05).On the day before operation,there were no significant differences in the levels of Cor,CRP and IL-2 between the two groups(P>0.05).On the first day after operation,the levels of Cor,CRP and IL-2 in both groups were increased,and the increase in the observation group was lower than that in the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.O5).Before intervention,there was no significant differ-ence in HAMD and HAMA scores between the two groups(P>0.05).After intervention,HAMD and HAMA scores were decreased in both groups,which were lower in the observation group than in the con-trol group(P<0.05).Conclusion Nursing intervention based on the concept of rapid rehabilitation in the perioperative period of colorectal cancer can promote the recovery of gastrointestinal function,alleviate the stress response of the body,reduce the incidence of postoperative complications,and relieve anxiety and depression.