Li Dong-Xia, Ye Wei, Yang Yi-Lu, Zhang Lei, Qian Xiang-Jun, Jiang Ping-Hua
Department of Pancreatic Hepatobiliary Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China.
World J Gastrointest Surg. 2023 Aug 27;15(8):1728-1738. doi: 10.4240/wjgs.v15.i8.1728.
Patients undergoing laparoscopic resection of liver metastases of colorectal cancer are prone to negative emotions and decrease of digestive function. Early nursing and psychological intervention are necessary.
To observe the effect of enhanced recovery nursing combined with mental health education on postoperative recovery and mental health of patients undergoing laparoscopic resection of liver metastases of colorectal cancer.
One hundred and twenty patients who underwent laparoscopic resection of liver metastases of colorectal cancer at our hospital between March 2021 and March 2023, were selected as participants. The patients admitted from March 1, 2021 to February 28, 2022 were set as the control group, and they were given routine nursing combined with mental health education intervention. While the patients admitted from March 1, 2022 to March 31, 2023 were set as the observation group, they were given accelerated rehabilitation surgical nursing combined with mental health education intervention. The differences in postoperative recovery-related indices, complications and pain degrees, and mental health-related scores were compared between groups. The T lymphocyte subset levels of the two groups were also compared.
The postoperative exhaust, defecation, eating and drainage time of the observation group were shorter than those of the control group. The pain scores of the observation group were lower than those of the control group at 6, 12, 24, 48, and 72 h after surgery. The cumulative complication rate of the observation group was lower than that of the control group ( < 0.05). The CD4+/CD8+ in the observation group was higher than that in the control group 3 d after surgery ( < 0.05). After intervention, the self-rating depression scale, self-rating anxiety scale, avoidance dimension, and yielding dimension in Medical coping style (MCMQ) scores of the two groups were lower than those prior to intervention, and the scores in the observation group were lower than those in the control group ( < 0.05). The face dimension score in the MCMQ score was higher than that before intervention, and that of the observation group was higher than that of the control group ( < 0.05). After intervention, the total scores of the life function index scale (FLIC) and psychological well-being scores of cancer patients in the two groups, and the physical and social well-being scores in the observation group, were higher than those before intervention. The nursing satisfaction of the observation group was higher than that of the control group ( < 0.05). The physical, psychological, and social well-being, and the total FLIC scores of the observation group were higher than those in the control group after surgery ( < 0.05).
Enhanced recovery nursing combined with mental health education can promote the recovery of gastrointestinal function, improve the mental health and quality of life of patients after laparoscopic resection of colorectal cancer liver metastases, and reduce the incidence of complications.
接受腹腔镜切除结直肠癌肝转移灶的患者容易出现负面情绪且消化功能下降。早期护理及心理干预很有必要。
观察加速康复护理联合心理健康教育对接受腹腔镜切除结直肠癌肝转移灶患者术后康复及心理健康的影响。
选取2021年3月至2023年3月在我院接受腹腔镜切除结直肠癌肝转移灶的120例患者作为研究对象。将2021年3月1日至2022年2月28日收治的患者设为对照组，给予常规护理联合心理健康教育干预。将2022年3月1日至2023年3月31日收治的患者设为观察组，给予加速康复外科护理联合心理健康教育干预。比较两组术后康复相关指标、并发症及疼痛程度、心理健康相关评分的差异。同时比较两组T淋巴细胞亚群水平。
观察组术后排气、排便、进食及引流时间均短于对照组。观察组术后6、12、24、48及72 h的疼痛评分低于对照组。观察组累积并发症发生率低于对照组（P<0.05）。观察组术后3 d的CD4+/CD8+高于对照组（P<0.05）。干预后，两组的自评抑郁量表、自评焦虑量表、医学应对方式问卷（MCMQ）中的回避维度和屈服维度评分均低于干预前，且观察组评分低于对照组（P<0.05）。MCMQ评分中的面对维度评分高于干预前，且观察组高于对照组（P<0.05）。干预后，两组癌症患者生活功能指数量表（FLIC）总分及心理健康评分，以及观察组的生理和社会健康评分均高于干预前。观察组护理满意度高于对照组（P<0.05）。术后观察组的生理、心理和社会健康状况及FLIC总分均高于对照组（P<0.05）。
加速康复护理联合心理健康教育可促进胃肠道功能恢复，改善结直肠癌肝转移灶腹腔镜切除术后患者的心理健康及生活质量，降低并发症发生率。
