CAJ | 학술논문

目的：探讨延续性护理对老年人胃大部切除术后早期并发症的影响。方法收集165例胃大部切除老年患者，随机分治疗组（82例）和对照组（83例），两组出院前均予外科常规护理，治疗组出院后续予延续性护理。记录患者的一般临床资料和出院前后并发症，统计分析患者的年龄、性别、基础疾病、手术方式、精神状态及炎症因子等因素与并发症的相关性，比较出院后两组患者的治疗依从性、再住院率、并发症和血清指标变化。结果入组患者出院时共57例出现并发症，研究显示除年龄外，性别、手术时间和方式、胃大切类型、精神状态、基础疾病均与并发症相关，术后贫血及炎症因子升高者更易有并发症；延续性护理后患者的治疗依从性、RBC计数、HGB和ALB均升高，CRP下降，并发症减少及再住院率降低。结论胃大切术后早期并发症与多因素相关，出院后延续性护理能有效提高老年人胃大切术后治疗依从性和临床疗效，减少术后并发症，该护理模式值得临床推广。
목적：탐토연속성호리대노년인위대부절제술후조기병발증적영향。방법수집165례위대부절제노년환자，수궤분치료조（82례）화대조조（83례），량조출원전균여외과상규호리，치료조출원후속여연속성호리。기록환자적일반림상자료화출원전후병발증，통계분석환자적년령、성별、기출질병、수술방식、정신상태급염증인자등인소여병발증적상관성，비교출원후량조환자적치료의종성、재주원솔、병발증화혈청지표변화。결과입조환자출원시공57례출현병발증，연구현시제년령외，성별、수술시간화방식、위대절류형、정신상태、기출질병균여병발증상관，술후빈혈급염증인자승고자경역유병발증；연속성호리후환자적치료의종성、RBC계수、HGB화ALB균승고，CRP하강，병발증감소급재주원솔강저。결론위대절술후조기병발증여다인소상관，출원후연속성호리능유효제고노년인위대절술후치료의종성화림상료효，감소술후병발증，해호리모식치득림상추엄。
Objective To investigate the effects of continuing nursing on early complications of elderly patients after subtotal gastrectomy. Methods One hundred and sixty-five patients aged≥60 after subtotal gastrectomy because of peptic ulcer or gastric tumors were randomly divided into 2 groups:treatment group (82 cases) and control group (83 cases). Prior to discharge all patients received routine nursing care, including keeping patient's diary, and continuity care, including health education, guide for diet, exercise, and drug taking, and knowledge about prevention of complications, was given to the patients of the treatment group in addition. Relevant data were analyzed retrospectively. Results Fifty seven of the 165 patients suffered from different complications. Age, gender, operation time and mode, mental status, underlying diseases, and postoperative anemia and elevated inflammatory factors were correlated with complications. Compared with the control group, the RBC count, and HGB level were significantly higher, and the rehospitalization rate, C-reactive protein level, and complication rate were significantly lower in the treatmeat group. Conclusion Multiple factores are associated with early complications after subtotal gastrectomy. Continuity care effectively raises the post-discharge treatment compliance and clinical effects, and reduces the early postoperative complication rate of the aged patients after subtotal gastrectomy.