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护理干预联合早期营养支持在低位直肠癌预防性造口回纳中的应用价值

Application value of nursing intervention combined with early nutritional support in preventive stoma reversion of low rectal cancer.

作者信息

Ye Xinmei, He Dandan, Zhao Jie, Lei Yuqing, Yao Qiuqiong, Wang Hui

机构信息

Department of Colorectal Anal Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510655, P.R. China.

出版信息

Oncol Lett. 2019 Apr;17(4):3777-3782. doi: 10.3892/ol.2019.10055. Epub 2019 Feb 19.

Abstract

Application value of nursing intervention combined with early nutritional support treatment in preventive stoma reversion of low rectal cancer was explored. Ninety-two cases of low rectal cancer patients undergoing preventive stoma reversion from January 2014 to December 2016 were retrospectively analyzed. All the patients had closed fistula 3 months after neostomy. Forty-four cases with routine nursing care were the control group; 48 cases with early nutritional support and nursing intervention were the experimental group. Nutritional status, psychological status, incidence of adverse reactions, wound infection rate, number of shaped and regular defecation were compared in the two groups. The levels of albumin, prealbumin and serum total protein in the experimental group were significantly higher than those in the control group after operation (P<0.05); the levels of albumin in the two groups after operation were significantly lower than those before operation (P<0.001). The SAS and SDS scores in the experimental group were significantly lower than those in the control group after operation (P<0.001); the SAS and SDS scores in the two groups after operation were significantly lower than those before operation (P<0.001). The number of abdominal pain, abdominal distention, diarrhea, incision infection and abdominal infection in the experimental group were less than those in the control group (P<0.05). The number of shaped and regular defecation cases in the experimental group was more than that in the control group (P<0.05). Nursing intervention combined with early nutritional support can improve the nutritional status, psychological anxiety-depression of the patients undergoing preventive stoma reversion, decrease the incidence of adverse reactions, and wound infection rate. It can also increase the shaped and regular defecation cases and is helpful for the recovery of intestinal function.

摘要

探讨护理干预联合早期营养支持治疗在低位直肠癌预防性造口回纳中的应用价值。回顾性分析2014年1月至2016年12月行预防性造口回纳的92例低位直肠癌患者。所有患者造口术后3个月均已关闭瘘口。44例采用常规护理的患者为对照组;48例采用早期营养支持及护理干预的患者为试验组。比较两组患者的营养状况、心理状态、不良反应发生率、伤口感染率、大便成形且规律的例数。试验组术后白蛋白、前白蛋白及血清总蛋白水平均显著高于对照组(P<0.05);两组术后白蛋白水平均显著低于术前(P<0.001)。试验组术后SAS及SDS评分均显著低于对照组(P<0.001);两组术后SAS及SDS评分均显著低于术前(P<0.001)。试验组腹痛、腹胀、腹泻、切口感染及腹腔感染例数均少于对照组(P<0.05)。试验组大便成形且规律的例数多于对照组(P<0.05)。护理干预联合早期营养支持可改善预防性造口回纳患者的营养状况、心理焦虑抑郁状态,降低不良反应发生率及伤口感染率,还可增加大便成形且规律的例数,有利于肠道功能恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/210f/6425359/06ba897cc16c/ol-17-04-3777-g00.jpg

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