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  本文關鍵詞：加速康復外科理念在肝癌患者術后護理中的應用研究　出處：《新疆醫(yī)科大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 加速康復外科 護理結(jié)局分類 手術 護理

【摘要】：目的:探討加速康復外科技術在原發(fā)性肝細胞癌患者部分肝切除術后護理中應用的有效性及安全性。方法:選取新疆某三級甲等腫瘤專科醫(yī)院肝膽胰外科2015年7月至2016年12月共130例原發(fā)性肝癌行肝切除手術治療的患者為研究對象,隨機分為加速康復外科組(ERAS組,n=65)、對照組(C組,n=65),ERAS組采用加速康復外科理念進行肝癌手術患者圍手術期護理,C組采用常規(guī)護理方法護理。比較兩組患者術后24h、48h、72h及1w的護理結(jié)局及指標評分、術后下床活動時間、腸道通氣時間、術后住院時間、住院費用、術后48h疼痛評分及患者護理滿意度。結(jié)果:1.基線結(jié)果:兩組患者在性別、年齡、診斷、術前肝功能儲備、手術方式等方面差異無統(tǒng)計學差異(P0.05),具有均衡可比性;2.術后24h ERAS組的護理結(jié)局焦慮水平、疼痛控制、睡眠、營養(yǎng)狀態(tài):食物和液體的攝入、知識:飲食、更換體位:主動、術后康復狀態(tài)評分與C組比較,差異有統(tǒng)計學意義(P0.05);術后48h ERAS組的焦慮水平、疼痛控制、睡眠、營養(yǎng)狀態(tài):食物和液體的攝入、更換體位:主動、術后康復狀態(tài)評分與C組比較,差異有統(tǒng)計學意義(P0.05);術后72h ERAS組的護理結(jié)局焦慮水平、疼痛控制、睡眠、術后康復狀態(tài)各指標評分與C組比較,差異均有統(tǒng)計學意義(P0.05);術后1w ERAS組術后康復狀態(tài)評分與C組比較差異有統(tǒng)計學意義(P0.05);3.臨床指標結(jié)果:干預后兩組患者術后下床活動時間、腸道通氣時間、術后住院天數(shù)、住院費用、術后48h疼痛評分及患者滿意度比較均有統(tǒng)計學意義(P0.05)。結(jié)論:加速康復外科技術在肝癌患者術后護理中的應用是安全、有效的,對患者術后焦慮水平、疼痛控制、睡眠等多個結(jié)局有積極的影響,可減少患者術后住院時間與住院費用,加快腸道恢復,促進早期恢復經(jīng)口飲食與下床活動,提高患者對護理工作滿意度。
[Abstract]:Objective: To investigate the safety and efficacy of accelerated rehabilitation surgery technique applied in nursing of patients with hepatocellular carcinoma after partial hepatectomy. Methods: in Xinjiang a three level of first-class hospital of hepatobiliary surgery from July 2015 to December 2016 a total of 130 cases of patients with primary surgical treatment for hepatic resection for hepatocellular carcinoma as the research object and randomly divided into accelerated rehabilitation surgery group (group ERAS, n=65), control group (C group, n=65 group, ERAS) by using the concept of accelerated rehabilitation surgery for liver cancer patients during operation period nursing, C group received the routine nursing care. The two groups were compared after treatment of 24h, 48h, and 72h and nursing outcome index the 1W score, the time of getting out of bed after operation, intestinal ventilation time, postoperative hospitalization time, cost of hospitalization, postoperative 48h pain score and nursing satisfaction of patients. Results: 1. baseline results: two groups in gender, age, diagnosis, preoperative liver function reserve The preparation, no statistically significant difference between the operation mode (P0.05), with a comparable level of anxiety; nursing outcomes, 24h ERAS group of 2. postoperative pain control, sleep, nutrition status: intake, food and liquid knowledge: diet, change posture: active, postoperative rehabilitation status score and C group comparison, the difference was statistically significant (P0.05); the level of anxiety, 48h ERAS group of postoperative pain control, sleep, food intake, and nutritional status: liquid change posture: active state, group C score and postoperative rehabilitation, the difference was statistically significant (P0.05); the anxiety level of nursing outcome, 72h ERAS group of postoperative pain control, sleep, compare the index status score and C group rehabilitation after operation, the differences were statistically significant (P0.05); 1W ERAS postoperative rehabilitation status score and C group had significant difference (P0.05); the 3. clinical indicators. Results: after the intervention of two groups of patients Get out of bed time, intestinal ventilation time, postoperative hospital stay, cost of hospitalization, postoperative 48h pain score and patient satisfaction were statistically significant (P0.05). Conclusion: the application of accelerated rehabilitation surgery in nursing in postoperative patients with hepatocellular carcinoma is safe, effective, for patients with postoperative anxiety, pain control, have the positive effects of sleep as a result, can reduce the postoperative hospitalization time and hospitalization costs, accelerate intestinal recovery, promote early recovery after eating and ambulation, improve patient satisfaction with nursing work.

【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.73

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