【摘要】 目的探讨加速康复外科(ERAS)指导的护理干预在3D腹腔镜下直肠癌手术患者中的应用。方法回顾性分析2017年1月—2018年1月本院肿瘤科收治的实施常规护理的50例3D腹腔镜下直肠癌根治术治疗患者的临床资料,将其纳入A组;另收集2018年2月—2019年2月本院肿瘤科收治的实施ERAS指导的护理干预的50例3D腹腔镜下直肠癌根治术治疗患者的临床资料,将其纳入B组,两组均干预至手术结束后,并观察至出院。比较两组患者手术指标、术中应激反应,并统计住院期间的并发症发生率。结果两组术中出血量对比,差异无统计学意义(P>0.05);与A组相比,B组手术用时长于A组,但术后排气时间、半流质饮食进食时间及住院时间均短于A组,差异有统计学意义(P<0.05);麻醉30 min时,两组肾上腺素(E)和血浆皮质醇(Cor)水平均高于麻醉前,但B组E、Cor水平低于A组,差异有统计学意义(P<0.05);相较A组,B组并发症发生率较低,差异有统计学意义(P<0.05)。结论 ERAS指导的护理干预在3D腹腔镜下直肠癌根治术中,能有效减弱术中应激反应,缩短术后排气时间、半流质饮食进食时间以及住院时间,还可减少并发症发生,利于患者预后。更多还原

【Abstract】 Objective To explore the application of nursing intervention guided by accelerated rehabilitation surgery(ERAS)in patients with rectal cancer underwent 3 D laparoscopic surgery.Methods A retrospective analysis was conducted on the clinical data of 50 patients received 3 D laparoscopic radical resection of rectal cancer and received routine nursing intervention who were admitted to the oncology department of our hospital from January 2017 to January 2018,the patients were included in group A.Clinical data of another 50 patients underwent 3 D laparoscopic radical resection of rectal cancer who were admitted to the department of oncology from February 2018 to February 2019 and received nursing intervention under the guidance of ERAS were collected, the patients were included in group B.The intervention measures continued until the end of the operation, and the observation lasted until discharge.The surgical indicators and intraoperative stress response were compared between the two groups of patients, and the incidence of complications during hospitalization was calculated.Results There was no significant difference in intraoperative blood loss between the two groups(P>0.05).Compared with group A,the operation time of group B was longer than that of group A,but the postoperative exhaust time, semi-liquid diet and hospitalization time were shorter than group A,the differences were statistically significant(P<0.05).At 30 minutes of anesthesia, the levels of adrenaline(E)and plasma cortisol(Cor)in the two groups were higher than those before anesthesia, but the levels of E and Cor in group B were lower than those in group A,the differences were statistically significant(P<0.05).Compared with group A,group B had a lower complication rate, and the difference was statistically significant(P<0.05).Conclusions The nursing intervention guided by ERAS during 3 D laparoscopic radical resection of rectal cancer could effectively reduce the stress response during the operation, shorten the postoperative exhaust time, the time of semi-liquid diet and the length of hospitalization, and it could also reduce the occurrence of complications, which is beneficial to the prognosis of the patients.更多还原