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结直肠癌术后患者的快速康复护理与生活质量

Rapid rehabilitation nursing in postoperative patients with colorectal cancer and quality of life.

作者信息

Xu Fang, Yu Peipei, Li Li

机构信息

Department of Rheumatic Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China.

Vasculocardiology Department, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China.

出版信息

Oncol Lett. 2019 Jul;18(1):651-658. doi: 10.3892/ol.2019.10379. Epub 2019 May 20.

Abstract

This study investigated the application of rapid rehabilitation nursing in postoperative patients with colorectal cancer (CRC) and its effect on quality of life (QOL). A prospective analysis was performed on 154 patients with CRC, after radical resection in The Central Hospital of Wuhan from February 2011 to April 2015. During the perioperative period, 96 patients (study group) received fast-track surgery (FTS) and 58 patients (control group) received routine surgery. The postoperative data of patients in the two groups were analyzed in terms of the first anus exhaustion time, the first time getting out of bed, first time eating liquid food, first defecation time, the time of drainage tube removal, time of gastric tube removal, time of suture removal, hospital stay and surgical expenses. Visual Analogue Scale (VAS) was used to assess postoperative pain. The re-hospitalization rate, the incidence of complications 30 days after operation, the survival and QOL scores were analyzed. After discharge patients were followed up for 3 years to observe the 3-year overall survival (OS). VAS scores were lower in the study group than that in the control group at 6, 12, 24, 48 and 72 h after operation (P<0.05). The re-hospitalization rate and incidence of complications 30 days after operation were lower in the study group than those in the control group (P<0.05). Before nursing, there was no statistically significant difference in QOL score between the two groups (P>0.05), whereas after 3 and 12 months of nursing, QOL score was significantly higher in the study group than that in the control group (P<0.05). QOL score in the two groups increased with time, and there were differences between the two groups at each time-point (P<0.05). There was no significant difference in the 3-year OS between the two groups (P>0.05). In conclusion, effectively improving patients' psychological state, reducing complications and relieving pain, the FTS during the perioperative period of CRC surgery promotes postoperative rehabilitation, reduces economic pressures and improves QOL.

摘要

本研究探讨了快速康复护理在结直肠癌(CRC)术后患者中的应用及其对生活质量(QOL)的影响。对2011年2月至2015年4月在武汉市中心医院接受根治性切除术后的154例CRC患者进行前瞻性分析。围手术期,96例患者(研究组)接受快速康复外科手术(FTS),58例患者(对照组)接受常规手术。分析两组患者术后首次肛门排气时间、首次下床时间、首次进食流食时间、首次排便时间、引流管拔除时间、胃管拔除时间、缝线拆除时间、住院时间及手术费用等数据。采用视觉模拟评分法(VAS)评估术后疼痛。分析再住院率、术后30天并发症发生率、生存率及生活质量评分。出院后对患者进行3年随访,观察3年总生存率(OS)。术后6、12、24、48及72小时,研究组VAS评分低于对照组(P<0.05)。研究组术后再住院率及术后30天并发症发生率低于对照组(P<0.05)。护理前,两组生活质量评分差异无统计学意义(P>0.05);而护理3个月及12个月后,研究组生活质量评分显著高于对照组(P<0.05)。两组生活质量评分均随时间升高,且各时间点两组间存在差异(P<0.05)。两组3年总生存率差异无统计学意义(P>0.05)。综上所述,CRC手术围手术期的FTS能有效改善患者心理状态,减少并发症,缓解疼痛,促进术后康复,减轻经济压力,提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75f3/6546976/3ca557f09b4c/ol-18-01-0651-g00.jpg

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