快速康复外科在喉癌围手术期护理中的应用

Application of fast track surgery in perioperative nursing of laryngeal carcinoma

摘要:

目的：探讨快速康复外科（fast track surgery，FTS）在喉癌围手术期护理中的应用效果。方法：选取扬州大学附属医院2016年7月至2019年12月收治的77例喉癌手术患者，征得患者同意，按随机分配原则将患者分为对照组（38例）和观察组（39例），对照组给予常规护理方法；观察组采用FTS围手术期护理方法。比较2组患者住院期间术后并发症、营养指标、术后平均住院天数、平均住院费用、患者满意度及焦虑自评量表（self-rating anxiety scale，SAS）和抑郁自评量表（self-rating depression scale，SDS）评分结果等护理指标。结果：观察组术后总并发症发生率为5.12%，明显低于对照组的14.91%，术后并发症的发生率差异有统计学意义（χ2=10.970，P=0.001）；出院前观察组患者血红蛋白、血清蛋白值明显高于对照组（P<0.05）；观察组术后平均住院天数为（10.00±1.05） d、平均住院费用为（36 943.00±2 101.90）元，均低于对照组，差异有统计学意义（P<0.05）；观察组满意度调查得分明显优于对照组，差异有统计学意义（P<0.05）；手术前后观察组SAS评分和SDS评分均低于对照组，差异有统计学意义（P<0.05）。结论：应用FTS对喉癌手术患者实施围手术期护理，可降低患者应激反应和术后并发症发生率，手术后患者身心恢复快、住院时间短。FTS围手术期护理方法是一种安全高效的新型护理模式，值得在临床护理工作中推广运用。

Abstract:

Objective：To explore the application effect of fast track surgery（FTS） in perioperative nursing of laryngeal carcinoma. Methods：This study recruited 77 patients with laryngeal carcinoma admitted to our hospital in July 2016 and December 2019. With the consent of the patients，the patients were randomized into control group（38 cases） and observation group（39 cases）. The control group were given routine nursing，the observation group were treated with FTS perioperative nursing，and the nursing indexes of pa－tients such as postoperative complications，nutritional indicators，average postoperative length of stay，average hospitalization expens－es，patient satisfaction，scoring results of self-rating anxiety scale（SAS） and self-rating depression scale（SDS） and so on during hos－pitalization between the two groups were compared. Results：The total incidence of postoperative complications in the observation group was 5.12%，significantly lower than that（14.91%） in the control group（χ2=10.970，P=0.001）. The values of hemoglobin and serum protein in the observation group before discharge were significantly higher than those in the control group（P<0.05）. The average post－operative hospital stay in the observation group was（10.00±1.05） days and the average hospital stay expense was （36 943.00±2 101.90） yuan，both significantly lower than those in the control group（P<0.05）. The satisfaction scores of patients in the observa－tion group were significantly better than those in the control group（P<0.05）. SAS and SDS scores of patients in the observation group were significantly lower than those in the control group before and after operation（P<0.05）. Conclusion：Patients with laryngeal car－cinoma treated with perioperative nursing by FTS can reduce the incidence of stress reaction and postoperative complications. The perioperative nursing of patients could acquire fast physical and mental recovery after the surgery and short-term hospital stay，which is a safe and efficient new nursing mode that is worthy of clini－cal nursing promotion and application.