CAJ | 학술논문

目的探讨快速康复外科(fast track surgery,FTS)模式在40例结直肠癌患者围术期护理中应用的安全性.方法将75例结直肠癌手术病人随机分成两组,使用快速康复外科方法治疗40例(快速康复组),使用传统方法治疗35例(传统方法组).分析研究两组病人术前、术后血清学检测指标,术后首次排气时间、住院天数、住院费用和并发症发生率,术后严格控制补液量为每天1 500～2 000 ml,2～3 d后停止输液,并于早期进食,术后充分止痛,本组患者均使用自控镇痛泵,在围术期护理过程,护理方法也相应地变动,不断改进符合FTS要求的护理措施.结果快速康复外科组与传统方法组相比,术后空腹血糖及胰岛素抵抗水平显著降低(P＜0.05),术后首次排气时间显著提前,体重下降减少,住院天数缩短,住院费用减少.结论结直肠癌患者按快速康复外科理念治疗,可有效控制术后高血糖,安全、有效,减少了住院时间与治疗费用,本组患者在围手术期应用快速康复外科模式护理中,未出现护理并发症和其他不良反应.因此护士可应用FTS模式更好地为患者服务.
목적 탐토쾌속강복외과(fast track surgery,FTS)모식재40례결직장암환자위술기호리중응용적안전성.방법 장75례결직장암수술병인수궤분성량조,사용쾌속강복외과방법치료40례(쾌속강복조),사용전통방법치료35례(전통방법조).분석연구량조병인술전、술후혈청학검측지표,술후수차배기시간、주원천수、주원비용화병발증발생솔,술후엄격공제보액량위매천1 500～2 000 ml,2～3 d후정지수액,병우조기진식,술후충분지통,본조환자균사용자공진통빙,재위술기호리과정,호리방법야상응지변동,불단개진부합FTS요구적호리조시.결과 쾌속강복외과조여전통방법조상비,술후공복혈당급이도소저항수평현저강저(P＜0.05),술후수차배기시간현저제전,체중하강감소,주원천수축단,주원비용감소.결론 결직장암환자안쾌속강복외과이념치료,가유효공제술후고혈당,안전、유효,감소료주원시간여치료비용,본조환자재위수술기응용쾌속강복외과모식호리중,미출현호리병발증화기타불량반응.인차호사가응용FTS모식경호지위환자복무.
Objective To investigate the safety by using fast track surgery (FTS) pattern in the perioperative period for 40 colorectal cancer patients. Methods 75 colorectal cancer patients were divided into two groups randomly, 40 in FTS pattern (FTS group) and 35 in traditional pattern (traditional group), Analysis and research on the detection of serological indicator before and after operation, the first exhaust time after operation, hospital stays, hospitalization expenses and incidence rate of complications. Replenishment quantity was controlled to be 1 500 ～ 2 000 ml strictly everyday after operation, 2 ～ 3 days to stop transfusion. FTS group was given food early and relieved pain fully after operation. Controlled analgesia pump was used for FTS group, and the nursing methods was changed, accordingly Perioperatire nursing methods were improved to adapt the FTS nursing measure continuously. Results Compared with those in traditional group, the fasting blood-glucose and insulin resistance levels of FTS group were greatly lower after operation ( P ＜ 0. 05 ) . The first exhaust time,weight loss, hospital stays and hospitalization expenses were greatly reduced after operation. Conclusions FPS pattern is safe and effective,hyperglycemia can be controlled effectively for FTS group, it can reduce hospital stays and hospitalization expenses. No complication or adverse reaction was occurred among the FTS group in the perioperative period. FTS pattern is useful way for nurse to serve the patients.