基于FTS理念的医护一体化护理干预在结直肠癌患者围术期中的应用研究

目的探讨基于快速康复外科(FTS)理念的医护一体化护理干预在结直肠癌患者围术期中的临床应用价值。方法选取2019年1月—2020年11月南阳市某医院收治的81例行手术治疗的结直肠癌患者为研究对象,采用随机数字表法分为研究组(41例)与对照组(40例),对照组患者给予常规护理,研究组患者给予基于FTS理念的医护一体化护理干预,2组患者均持续护理7 d。比较2组患者护理前后胃动素(MTL)、生长抑素(SS)及D-乳酸(D-LA)水平,焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,比较2组患者并发症发生情况。结果护理前,2组患者血清MTL,SS及D-LA水平比较,差异均无统计学意义(P>0.05)。护理后,2组患者血清MTL水平高于护理前,研究组高于对照组,差异均有统计学意义(P<0.05);D-LA水平高于护理前,但研究组低于对照组,差异均有统计学意义(P<0.05);SS水平均高于护理前,差异均有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05)。护理前,2组患者SDS及SAS评分比较,差异均无统计学意义(P>0.05);护理后,研究组患者的SDS及SAS评分均低于对照组,差异均有统计学意义(P<0.05)。对照组患者的并发症发生率为17.50%,高于研究组的4.88%,但差异无统计学意义(χ²=3.608,P=0.058)。结论基于FTS理念的医护一体化护理干预,可有效改善结直肠癌手术患者围术期的负性情绪,促进术后胃肠道功能恢复,可在临床上推广应用。

Study on the application of integrated medical and nursing intervention based on the FTS concept in the perioperative period of colorectal cancer

Objective To explore the clinical application value of integrated medical and nursing care intervention based on the concept of fast track surgery(FTS)in the perioperative period of colorectal cancer patients.Methods Eighty-one patients with colorectal cancer treated with surgery in a hospital in Nanyang city from January 2019 to November 2020 were selected as the study subjects,and were divided into the study group(41 cases)and the control group(40 cases)using the random number table method.Patients in the control group were given conventional nursing care while patients in the study group received integrated medical and nursing care intervention based on the FTS concept;the treatment in both groups lasted for 7 days.The levels of motilin(MT),somatostatin(SS)and d-lactate(D-LA),and the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were compared before and after care,and the occurrence of complications was compared between the two groups.Results Before care,serum MTL,SS and D-LA levels of patients in the 2 groups were compared,and the differences were not statistically significant(P>0.05).After care,the serum MTL levels of patients in the 2 groups were higher than before care,and the study group was higher than the control group,with statistically significant differences(P<0.05);the D-LA levels were higher than before care,but the study group was lower than the control group,and the differences were statistically significant(P<0.05);the SS levels were higher than before care,and the differences were statistically significant(P<0.05),but the differences between the groups were not statistically significant(P>0.05).Before care,the differences in SDS and SAS scores were not statistically significant(P>0.05)when compared between the 2 groups.After care,the SDS and SAS scores of patients in the study group were lower than those in the control group,and the differences were all statistically significant(P<0.05).The complication rate of patients in the control group was 17.50%,which was higher than that of 4.88%in the study group,but the difference was not statistically significant(χ²=3.608,P=0.058).Conclusion The integrated medical and nursing intervention based on the FTS concept can effectively improve the negative perioperative emotions of colorectal cancer surgery patients and promote the recovery of postoperative gastrointestinal function,which can be promoted and applied in clinical practice.