Li Yu-Qin, Liu Ying, Peng Zhu-Qing, Fang Rong, Xu Hai-Yan
Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan 430033, Hubei Province, China.
Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China.
World J Clin Cases. 2024 Aug 6;12(22):4983-4991. doi: 10.12998/wjcc.v12.i22.4983.
Gastric cancer-related morbidity and mortality rates are high in China. Patients who have undergone gastric cancer surgery should receive six cycles of chemotherapy according to their condition. During this period, intestinal obstruction is likely to occur. Electrolyte balance disorders, peritonitis, intestinal necrosis, and even hypovolemic shock and septic shock can seriously affect the physical and mental recovery of patients and threaten their health and quality of life (QoL).
To quantitatively explore the effects of enhanced recovery after surgery (ERAS)-based nursing on anxiety, depression, and QoL of elderly patients with postoperative intestinal obstruction after gastric cancer.
The clinical data of 129 older patients with intestinal obstruction after gastric cancer surgery who were treated and cared for in our hospital between January 2019 and December 2021 were examined retrospectively. Nine patients dropped out because of transfer, relocation, or death According to the order of admissions, the patients were categorized into either a comparison group or an observation group according to the random number table, with 60 cases in each group.
After nursing care, the observation group required significantly less time to eat for the first time, recover bowel sounds, pass gas, and defecate than the comparison group ( < 0.05). No significant difference was noted in nutrition-related indicators between the two groups before care. Before care, the Symptom Check List-90 scores between the two groups were comparable, whereas anxiety, depression, paranoia, fear, hostility, obsession, somatization, interpersonal sensitivity, and psychotic scores were significantly lower in the observation group after care ( < 0.05). The QoL scores between the two groups before care did not differ significantly. After care, the physical, social, physiological, and emotional function scores; mental health score; vitality score; and general health score were significantly higher in the observation group, whereas the somatic pain score was significantly lower in the observation group ( < 0.05).
ERAS-based nursing combined with conventional nursing interventions can effectively improve patient's QoL, negative emotions, and nutritional status; accelerate the time to first ventilation; and promote intestinal function recovery in elderly patients with postoperative intestinal obstruction after gastric cancer surgery.
中国胃癌相关的发病率和死亡率很高。接受胃癌手术的患者应根据病情接受六个周期的化疗。在此期间，可能会发生肠梗阻。电解质平衡紊乱、腹膜炎、肠坏死，甚至低血容量性休克和感染性休克会严重影响患者的身心恢复，并威胁其健康和生活质量（QoL）。
定量探讨基于术后加速康复（ERAS）的护理对老年胃癌术后肠梗阻患者焦虑、抑郁及生活质量的影响。
回顾性分析2019年1月至2021年12月在我院接受治疗和护理的129例老年胃癌术后肠梗阻患者的临床资料。9例患者因转院、搬迁或死亡退出研究。根据入院顺序，按照随机数字表将患者分为对照组和观察组，每组60例。
护理后，观察组首次进食、肠鸣音恢复、排气和排便所需时间均显著少于对照组（P<0.05）。护理前两组营养相关指标无显著差异。护理前，两组症状自评量表-90评分相当，而护理后观察组的焦虑、抑郁、偏执、恐惧、敌对、强迫、躯体化、人际敏感和精神病性评分显著更低（P<0.05）。护理前两组生活质量评分无显著差异。护理后，观察组身体、社会、生理和情感功能评分、心理健康评分、活力评分和总体健康评分显著更高，而观察组躯体疼痛评分显著更低（P<0.05）。
基于ERAS的护理联合传统护理干预可有效改善老年胃癌术后肠梗阻患者的生活质量、负面情绪和营养状况；加快首次通气时间；促进肠道功能恢复。
