全程护理模式在结直肠肿瘤加速康复外科中的应用及临床价值

目的探讨全程护理模式在结直肠肿瘤加速康复外科围手术期中应用的临床价值及地位。 方法选择2015年7月1日至2016年7月1日行腹腔镜手术治疗的150例结直肠癌患者作为研究对象，随机分为全程护理组75例和对照组75例，围手术期对照组只采用加速康复护理，全程护理组在加速康复护理的基础上予以全程护理干预，全程护理组医师与责任护士协同患者整个住院期间的诊治护理，协同主管医生及时调整治疗方案，进一步强化加速康复措施的执行。比较两组患者术后肛门首次排气排便时间、术后首次进食时间、术后下床时间、总住院时间，以及尿潴留、腹胀、肺部感染、术后疼痛、低蛋白血症等并发症的发生率。 结果全程护理组首次排便时间（t=-13.49，P=0.034）、术后首次下床时间（t=17.067，P=0.044）、术后进食时间（t=9.704，P<0.01）、总住院时间（t=-0.195，P=0.045）均小于对照组，其在术后并发症肺部感染（χ²=4.807，P=0.028）、疼痛（χ²=5.021，P<0.025）等方面也优于对照组，差异均有统计学意义（均P<0.05）。 结论全程护理模式在结直肠肿瘤加速康复外科围术期中具有优化各项护理举措，为患者提供全程、系统、延续的整体护理，对减少术后并发症，提高患者满意度，缩短患者住院时间具有积极的临床意义。

Application and clinical value of whole course nursing mode in colorectal cancer accelerated rehabilitation surgery

ObjectiveTo explore the clinical value of whole nursing model in enhanced recovery after surgery (ERAS) in perioperative colorectal surgery. MethodsChose 150 patients with colorectal cancer who underwent laparoscopic surgery from July 2015 to July 2016 were selected as the subjects, they were randomly divided into the whole course nursing group (75 cases) and the control group (75 cases), perioperative control group with accelerated rehabilitation nursing, nursing group were given nursing intervention on the basis of accelerated rehabilitation nursing, the whole nursing group nurses and doctors cooperate with the patients during the whole hospital during the diagnosis and treatment of nursing, cooperate with doctors to adjust treatment plan in time, further promoting the implementation of accelerated rehabilitation measures. Compared two groups of patients with postoperative anal exhaust defecation time, postoperative eating for the first time, postoperative ambulation time, hospitalization time, and the incidence of complications such as urinary retention, abdominal distension, pulmonary infection, postoperative pain, hypoproteinemia and other complications. ResultsIn the whole nursing group, the first defecation time (t=-13.49, P=0.034), the first postoperative ambulation time (t=17.067, P=0.044), the postoperative eating time (t=9.704, P<0.01), and total hospitalization time (t=-0.195, P=0.045) were less than the control group, the complications of postoperative pulmonary infection (χ²=4.807, P=0.028), pain (χ²=5.021, P<0.025) were also better than the control group, the differences were statistically significant (P< 0.05) . ConclusionThe whole nursing mode in colorectal surgery system provide patients with a full, systematic, continuous holistic care. Furthermore, the model can reduce the postoperative complications, improve patient′s satisfaction, shorten the hospitalization time of patients with positive significance.