基于时机理论的护理联合营养干预对胃癌内镜黏膜下剥离术患者术后视觉模拟疼痛评分法评分及胃肠道功能恢复的影响

Effect of timing-based theoretical nursing combined with nutritional intervention on postoperative visual analogue scale scores and gastrointestinal function recovery in patients with gastric cancer undergoing endoscopic submucosal dissection

目的探讨基于时机理的论护理联合营养干预对胃癌内镜黏膜下剥离术(ESD)患者术后视觉模拟疼痛评分(VAS)、胃肠道功能恢复的影响。方法选取2019年1月至2022年1月在南京医科大学附属无锡人民医院接受ESD治疗的82例胃癌患者作为研究对象,采用电脑随机数字表法分为对照组与观察组,每组41例。对照组行常规护理,观察组在常规护理的基础上展开基于时机理论的护理联合营养干预。比较两组术后VAS评分、胃肠功能恢复情况及生命质量。结果术后24、48、72 h时,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。干预后,两组血清胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)水平均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组肠鸣音恢复、肛门排气、首次排便、首次进食时间均短于对照组,差异有统计学意义(P<0.05)。干预后,两组环境、生理、心理、社会关系评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论基于时机理论的护理与营养干预联合用于胃癌ESD可有效减轻患者术后疼痛,促进胃功能恢复,并进一步改善其生命质量。

Objective To investigate the effect of timing-based theoretical nursing combined with nutritional intervention on postoperative visual analogue scale(VAS)scores and gastrointestinal function recovery in patients with gastric cancer undergoing endoscopic submucosal dissection(ESD).Methods A total of 82 patients with gastric cancer who received ESD treatment in Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2019 to January 2022 were selected as the research subjects,and they were divided into the control group and the observation group according to computer digital table method,with 41 cases in each group.The control group were received routine nursing,and the observation group was given timing-based theoretical nursing combined with nutritional intervention on the basis of routine nursing.The postoperative VAS score,gastrointestinal function recovery and quality of life were compared between the two groups.Results At 24,48 and 72 h after operation,VAS scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After intervention,serum gastrin(GAS),motilin(MTL)and vasoactive intestinal peptide(VIP)of the two groups were higher than before intervention,and observation group was higher than control group,the differences were statistically significant(P<0.05).The time of bowel sound recovery,anal exhaust,first defecation and first feeding in the observation group was shorter than that in the control group,and the differences were statistically significant(P<0.05).After intervention,the scores of environmental,physiological,psychological and social relations of the two groups were higher than before intervention,and observation group was higher than control group,the differences were statistically significant(P<0.05).Conclusion The timing-based theoretical nursing combined with nutritional intervention can effectively relieve postoperative pain in patients with gastric cancer ESD,promote the effective recovery of gastric function,as well as further improve their quality of life.