浅析早期综合护理干预对于胃癌术后患者胃功能的影响 孙洪波

浅析早期综合护理干预对于胃癌术后患者胃功能的影响孙洪波

发表时间：2019-05-13T16:47:25.430Z 来源：《健康世界》2019年3期作者：孙洪波

[导读] 为了客观评估胃癌术后早期综合护理干预对于患者胃功能恢复的作用，本校附院开展本次研究，现报道如下。

伊春市中医医院 153000

摘要：目的：探讨并分析胃癌术后早期行综合护理干预对患者胃功能、并发症发生率以及生活质量的影响。方法：此次研究的对象是选取本院2015年1月-2016年1月护理的胃癌手术治疗患者68例，将其临床资料进行回顾性分析，并按照随机数字表法将其分为常规组与观察组，各34例。常规组采取常规基础术后护理，观察组在常规组的基础上给予术后早期综合护理干预；观察两组术后疼痛、腹胀程度，胃肠功能各项指标的恢复时间，术后并发症的发生情况；出院时评估两组心理状态、生活状态并调查患者对护理工作的满意程度。结果：观察组术后腹胀与疼痛程度均轻于常规组（P<0.05）；观察组术后正常进食的时间、肠鸣音的恢复时间、自主排氣时间、正常排便时间、下床活动时间以及住院时间均少于常规组（P<0.05）；观察组术后胃乏力及并发症总发生率均低于常规组（P<0.05）；观察组心理状态明显优于常规组（P<0.05）；观察组SF-36量表中身体功能、角色功能、症状以及整体健康均优于常规组（P<0.05）；两组认知功能、社会功能比较，差异均无统计学意义（P>0.05）；观察组总满意率为88.24%，常规组为55.88%，观察组总满意率高于常规组（P<0.05）。结论：早期综合护理干预可促进胃癌手术治疗患者术后胃肠功能尽早恢复，降低术后早期疼痛与腹胀程度，预防继发性心理疾病的发生，改善患者术后生活质量，全面提高患者对于护理工作的满意程度，值得于胃癌术后临床护理中推广应用。

关键词：胃癌；术后早期护理；综合护理；胃功能

[abstract] Objective：To explore and analyze the effect of early comprehensive nursing intervention on gastric function，complication rate and quality of life of patients with gastric cancer after operation. Methods：68 patients with gastric cancer treated by surgery in our hospital from January 2015 to January 2016 were selected and their clinical data were retrospectively analyzed. They were divided into routine group and observation group according to random number table method，34 cases in each group. Routine basic post-operative nursing was adopted in the routine group，while early comprehensive nursing intervention was given in the observation group on the basis of routine group. The degree of pain，abdominal distension，recovery time of gastrointestinal function indexes and occurrence of postoperative complications were observed in the two groups. The psychological and living conditions of the two groups were evaluated at discharge and the satisfaction degree of patients with nursing work was investigated. Results：The degree of abdominal distension and pain in the observation group was less than that in the routine group（P < 0.05）；the time of normal eating，recovery of bowel sounds，time of spontaneous exhaust，time of normal defecation，time of getting out of bed and time of hospitalization in the observation group were less than those in the routine group（P < 0.05）；the total incidence of gastric fatigue and complications in the observation group were lower than those in the routine group（P < 0.05）. The physical state of the observation group was significantly better than that of the conventional group（P < 0.05）；the physical function，role function，symptoms and overall health of the SF-36 scale in the observation group were better than those of the conventional group（P < 0.05）；there was no significant difference in cognitive function and social function between the two groups（P > 0.05）；the total satisfaction rate of the observation group was 88.24%，the conventional group was 55.88%，and the total satisfaction rate of the observation group was higher than that of the conventional group（P < 0.05）. Conclusion：Early comprehensive nursing intervention can promote the early recovery of gastrointestinal function，reduce the degree of early pain and abdominal distension after operation，prevent the occurrence of secondary psychological diseases，improve the quality of life of patients after operation，and comprehensively improve the satisfaction of patients with nursing work. It is worth popularizing and applying in the clinical nursing of patients with gastric cancer after operation. [Key words] Gastric cancer；Early postoperative nursing；Comprehensive nursing；Gastric function

胃癌是消化科临床上一种十分常见的恶性肿瘤。我国近些年来的发病率呈现出上升趋势[1-3]。手术切除治疗胃癌具有理想疗效及预后，早期胃癌手术治疗的五年生存率可达90%左右[4-6]。然而手术治疗属于有创性疗法，术后患者可发生一系列的相关不良反应，严重的甚至可能直接影响手术疗效。近些年来术后快速康复理念在临床护理中推广普及，术后早期综合护理干预正是建立在此项理论基础之上的新型优质护理措施。为了客观评估胃癌术后早期综合护理干预对于患者胃功能恢复的作用，本校附院开展本次研究，现报道如下。

1 资料与方法

1.1 一般资料

选取本校附属医院2015年1月-2016年1月护理的胃癌手术治疗患者68例纳入本次研究，按照随机数字表法将其分为常规组与观察组，各34例。常规组中男19例，女15例；年龄43～75岁，平均（65.37±8.26）岁；TNM分期：Ⅱ期19例，Ⅲ期15例；肿瘤数量：多发2例，单发32例；肿瘤位置：胃窦3例，胃体18例，胃底11例，多部位2例。观察组中男20例，女14例；年龄44～76岁，平均（65.45±8.71）岁；TNM分期：Ⅱ期18例，Ⅲ期16例；肿瘤数量：多发3例，单发31例；肿瘤位置：胃窦2例，胃体16例，胃底13例，多部位3例。两组患者一般资料比较差异无统计学意义（P>0.05），具有可比性。

1.2 纳入与排除标准

纳入标准：患者均经本校附院医学影像学诊断为胃部恶性肿瘤并接受手术切除治疗，术中切除组织经病理检验确诊为胃癌。患者均在完全知晓本次研究的前提下自愿参与并签署了知情同意声明文件。本次研究报请本院伦理委员会批准并全程监督。排除标准：淋巴转移、远端转移的胃癌患者；其他脏器恶性肿瘤患者；自身免疫功能障碍患者、凝血功能障碍患者；进食梗阻疾病患者；合并心肺脑血管严重疾病患者；入组前有放化疗史患者；肿瘤侵犯至食管下段需行胸腹联合切口患者；重大器官功能衰竭患者；合并腹水、胸腔积液患者；合并有消化系统穿孔、幽门梗阻等于术前需禁食的患者；精神疾病或意识功能障碍患者。

1.3 护理方法

1.3.1 常规组常规组采取常规术后护理，包括术后常规生命体征监护、症状体征观察、常规抗感染、药物及留置管道等常规护理、术