CAJ | 학술논문

目的探讨医护—体化护理干预促进食管癌患者快速康复的临床效果.方法选取2011年1-6月接受食管癌根治术的食管鳞癌患者117例,将4-6月接受手术的63例患者设为研究组,围手术期采用快速康复理念进行处理,1-3月接受手术的54例患者设为对照组,围手术期给予常规护理.比较两组患者手术前后营养指标、术后恢复情况及并发症发生情况.结果手术前两组患者ALB、PAB、TRF水平比较,差异均无统计学意义(P＞0.05)；术后第8天时,两组患者ALB水平比较,差异无统计学意义(P＞0.05)；术后研究组患者PAB、TRF分别为(0.22±0.04),(1.72±0.38) g/L,均高于对照组的(0.18 ±0.04),(1.53±0.36)g/L,差异均有统计学意义(t分别为4.723 4,2.762 2;P＜0.01)；研究组患者术后胃肠减压引流量、术后排气时间、术后拔除胸腔引流管时间、术后住院时间及住院总费用均显著低于对照组,差异均有统计学意义(t分别为38.709,-62.367,-29.403,-15.415,-14.760;P＜0.01)；研究组和对照组术后并发症的发生率分别为7.9％和24.1％,差异有统计学意义(x2=5.817,P＜0.05).结论医护一体化护理干预可以促进食管癌患者快速康复,改善患者临床结局.
목적 탐토의호—체화호리간예촉진식관암환자쾌속강복적림상효과.방법 선취2011년1-6월접수식관암근치술적식관린암환자117례,장4-6월접수수술적63례환자설위연구조,위수술기채용쾌속강복이념진행처리,1-3월접수수술적54례환자설위대조조,위수술기급여상규호리.비교량조환자수술전후영양지표、술후회복정황급병발증발생정황.결과 수술전량조환자ALB、PAB、TRF수평비교,차이균무통계학의의(P＞0.05)；술후제8천시,량조환자ALB수평비교,차이무통계학의의(P＞0.05)；술후연구조환자PAB、TRF분별위(0.22±0.04),(1.72±0.38) g/L,균고우대조조적(0.18 ±0.04),(1.53±0.36)g/L,차이균유통계학의의(t분별위4.723 4,2.762 2;P＜0.01)；연구조환자술후위장감압인류량、술후배기시간、술후발제흉강인류관시간、술후주원시간급주원총비용균현저저우대조조,차이균유통계학의의(t분별위38.709,-62.367,-29.403,-15.415,-14.760;P＜0.01)；연구조화대조조술후병발증적발생솔분별위7.9％화24.1％,차이유통계학의의(x2=5.817,P＜0.05).결론 의호일체화호리간예가이촉진식관암환자쾌속강복,개선환자림상결국.
Objective To study the clinical effect of all-in-one nursing intervention to promote esophageal cancer patients' recovery.Methods 117 patients with esophageal squamous cell carcinoma who had radical resection of esophageal carcinoma from Jan to Jun 2011 were enrolled in this study.63 cases who had surgery from April to June 2011 were the research group and received nursing under fast recovery theory during perioperative period,while 54 cases who had surgery from January to March were the control group and received conventional nursing.Two groups' nutritional indexs before and after surgery,recovery after surgery and the incidence of complication was compared.Results There was no significant difference in patients' ALB,PAB and TRF levels between two groups before surgery (P ＞ 0.05).There was no significant difference in patients' ALB between two groups on the 8th day after the surgery (P ＞ 0.05).The PAB and TRF of patients in the research group after surgery were respectively (0.22 ±0.04) and (1.72 ±0.38) g/L,both higher than those in the control group [(0.18 ± 0.04) and (1.53 ± 0.36) g/L],and the differences were statistically significant (t =4.723 4,2.762 2,respectively; P ＜ 0.01).The drainage of gastrointestinal decompression,exsufflation time,time for removing pleural cavity drainage tube,time in hospital and cost of hospitalization after surgery were all lower in the research group than in the control group,and the differences were statistically significant (t =38.709,-62.367,-29.403,-15.415,-14.760,respectively; P ＜ 0.01).The incidence rate of postoperative complication was 7.9％ in the research group and 24.1％ in the control group,and the difference was statistically significant (x2 =5.817,P ＜ 0.05).Conclusions All-in-one nursing intervention can promote esophageal cancer patients' quick recovery,so as to improve their clinical outcome.