摘要
目的探讨在全腔镜食管癌患者的手术过程中快速康复理念指导下优化护理措施的价值。方法选择食管癌手术患者80例,随机分为实验组(n=42)和对照组(n=38),实验组采用预置营养管和术中预防低温的护理措施;对照组采用常规术后放置鼻空肠营养管的方法。比较两组患者置入营养管时间、术后鼻腔出血和会厌部水肿、肺部感染、肺不张、呼吸功能衰竭发生情况以及炎症因子(肿瘤坏死因子α、C反应蛋白、白介素6)水平的差异。结果实验组所需插管时间(5.1±0.8)min,明显短于对照组的(8.2±1.3)min(P<0.05);术后鼻腔出血、会厌部水肿、肺部感染、肺不张和呼吸功能衰竭的发生率均显著低于对照组(P<0.05),术后24 h炎症因子水平也明显低于对照组(P<0.05)。结论通过预置营养管、术中保温的方法可以缩短营养管插管时间,降低术后鼻腔出血和会厌部水肿、肺部感染、肺不张和呼吸功能衰竭的发生率,降低术后炎症因子水平,促进患者快速康复,值得临床推广使用。
Objective To evaluate the value of optimal nursing care under the guidance of rapid rehabilitation concept in the operation of patients with total laparoscopic esophageal cancer.Methods Eighty patients with esophageal cancer surgery were randomly divided into experimental group(42 cases)and control group(38 cases).The nursing measures adopted in the experimental group are presetting nutrition tube and intraoperative prevention of low temperature while in the control group conventional postoperative nasal jejunal nutrition tubes were placed.The clinical data in two groups including the time of the placement of nutrient tube,postoperative nasal bleeding and epiglottis edema,pulmonary infection,atelectasis,respiratory failure and inflammatory factors(tumor necrosis factor alpha,C-reactive protein,interleukin-6)were recorded and analyzed.Results The intubation time required by the experimental group was(5.1±0.8)min,which was significantly shorter than that of the control group(8.2±1.3)min(P<0.05).The incidence of postoperative nasal bleeding,epiglottic edema,pulmonary infection,atelectasis and respiratory failure was lower than those of the control group(P<0.05).The level of inflammatory factors 24h after surgery was also significantly lower than that of the control group(P<0.05).Conclusions Presetting nutrition tube and intraoperative warming method can shorten the intubation time of nutrient tube,reduce the incidence of postoperative nasal bleeding and epiglottis edema,pulmonary infection,atelectasis and respiratory failure,and also the postoperative inflammatory factors,which promotes rapid recovery of patients and is worthy of clinical promotion.
作者
严俊丽
张建友
王林
施庆彤
Yan Junli;Zhang Jianyou;Wang Lin;Shi Qingtong(Department of Operation Room,The Affiliated Hospital of Yangzhou University,Yanzhou 225000,China;Department of Anesthesiology,The Affiliated Hospital of Yangzhou University,Yanzhou 225000,China;Department of Thoracic Surgery,The Affiliated Hospital of Yangzhou University,Yanzhou 225000,China)
出处
《中华胸部外科电子杂志》
2019年第4期243-247,共5页
CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition
关键词
食管癌
营养管
快速康复
Esophageal cancer
Nutrient canal
Rapid rehabilitation
