本文關(guān)鍵詞：加速康復(fù)外科理念在肝癌患者術(shù)后護(hù)理中的應(yīng)用研究　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 加速康復(fù)外科 護(hù)理結(jié)局分類 手術(shù) 護(hù)理

【摘要】：目的:探討加速康復(fù)外科技術(shù)在原發(fā)性肝細(xì)胞癌患者部分肝切除術(shù)后護(hù)理中應(yīng)用的有效性及安全性。方法:選取新疆某三級(jí)甲等腫瘤�？漆t(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(shù)治療的患者為研究對(duì)象,隨機(jī)分為加速康復(fù)外科組(ERAS組,n=65)、對(duì)照組(C組,n=65),ERAS組采用加速康復(fù)外科理念進(jìn)行肝癌手術(shù)患者圍手術(shù)期護(hù)理,C組采用常規(guī)護(hù)理方法護(hù)理。比較兩組患者術(shù)后24h、48h、72h及1w的護(hù)理結(jié)局及指標(biāo)評(píng)分、術(shù)后下床活動(dòng)時(shí)間、腸道通氣時(shí)間、術(shù)后住院時(shí)間、住院費(fèi)用、術(shù)后48h疼痛評(píng)分及患者護(hù)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(shù)前肝功能儲(chǔ)備、手術(shù)方式等方面差異無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),具有均衡可比性;2.術(shù)后24h ERAS組的護(hù)理結(jié)局焦慮水平、疼痛控制、睡眠、營(yíng)養(yǎng)狀態(tài):食物和液體的攝入、知識(shí):飲食、更換體位:主動(dòng)、術(shù)后康復(fù)狀態(tài)評(píng)分與C組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后48h ERAS組的焦慮水平、疼痛控制、睡眠、營(yíng)養(yǎng)狀態(tài):食物和液體的攝入、更換體位:主動(dòng)、術(shù)后康復(fù)狀態(tài)評(píng)分與C組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后72h ERAS組的護(hù)理結(jié)局焦慮水平、疼痛控制、睡眠、術(shù)后康復(fù)狀態(tài)各指標(biāo)評(píng)分與C組比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后1w ERAS組術(shù)后康復(fù)狀態(tài)評(píng)分與C組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);3.臨床指標(biāo)結(jié)果:干預(yù)后兩組患者術(shù)后下床活動(dòng)時(shí)間、腸道通氣時(shí)間、術(shù)后住院天數(shù)、住院費(fèi)用、術(shù)后48h疼痛評(píng)分及患者滿意度比較均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:加速康復(fù)外科技術(shù)在肝癌患者術(shù)后護(hù)理中的應(yīng)用是安全、有效的,對(duì)患者術(shù)后焦慮水平、疼痛控制、睡眠等多個(gè)結(jié)局有積極的影響,可減少患者術(shù)后住院時(shí)間與住院費(fèi)用,加快腸道恢復(fù),促進(jìn)早期恢復(fù)經(jīng)口飲食與下床活動(dòng),提高患者對(duì)護(hù)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(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.73

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