加速康复外科护理在乳腺癌围手术期护理中的应用
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摘要
目的探讨加速康复外科护理(ERAS)在乳腺癌围术期护理中的应用价值。方法选取2015年1月至2017年5月间乐山市人民医院收治的156例行乳腺癌改良根治术患者的临床资料。按采用的护理方法不同将所有患者分为两组。引入加速康复外科护理理念护理的78例患者纳入试验组,采用常规护理的78例患者纳入对照组。观察两组患者术后并发症的发生情况和患侧上肢功能恢复情况。结果两组患者的皮瓣积液、皮瓣坏死和伤口麻木等的发生率比较,差异无统计学意义(P> 0. 05)。试验组患者的伤口感染、上肢水肿和上肢麻木等的发生率明显低于对照组患者,差异均有统计学意义(均P <0. 05)。术后试验组患者心理障碍发生率明显低于对照组,差异有统计学意义(P <0. 05)。讨论加速康复外科护理模式用于乳腺癌围手术期护理,对患者患侧肢体功能恢复及心理健康具有正面的促进作用,且能减少部分并发症的发生率及降低心理障碍的发生率。
Objective To investigate the effect of enhanced recovery after surgery(ERAS) in perioperative nursing care of patients with breast cancer. Methods Clinical data of 156 patients who underwent modified radical mastectomy at Leshan Hospital from January 2015 to May 2017 were selected. According to different nursing strategies patients received,the subjects were randomly divided into two groups with 78 patients in each group. The experimental group received ERAS care and treatment and the control group received routine care. The incidence of postoperative complications,the recovery of the upper limb function and psychological trauma were observed in the two groups. Results There was no significant difference in the incidence of subcutaneous flaps,skin flap necrosis and wound numbness between the experimental group and the control group(P > 0. 05). The incidence of wound infection,upper limb edema and numbness in the experimental group was lower compare to the control group(all P < 0. 05). The incidence of psychological disorder after operation was significantly lower in the experimental group than in the control group(P < 0. 05). Conclusion ERAS can promote perioperative recovery and the functional recovery of affected limbs,and reduce the incidence of some complications and psychological disorder in patients with breast cancer undergoing modified radical mastectomy.
Objective To investigate the effect of enhanced recovery after surgery(ERAS) in perioperative nursing care of patients with breast cancer. Methods Clinical data of 156 patients who underwent modified radical mastectomy at Leshan Hospital from January 2015 to May 2017 were selected. According to different nursing strategies patients received,the subjects were randomly divided into two groups with 78 patients in each group. The experimental group received ERAS care and treatment and the control group received routine care. The incidence of postoperative complications,the recovery of the upper limb function and psychological trauma were observed in the two groups. Results There was no significant difference in the incidence of subcutaneous flaps,skin flap necrosis and wound numbness between the experimental group and the control group(P > 0. 05). The incidence of wound infection,upper limb edema and numbness in the experimental group was lower compare to the control group(all P < 0. 05). The incidence of psychological disorder after operation was significantly lower in the experimental group than in the control group(P < 0. 05). Conclusion ERAS can promote perioperative recovery and the functional recovery of affected limbs,and reduce the incidence of some complications and psychological disorder in patients with breast cancer undergoing modified radical mastectomy.
引文
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[2]汪志伟,李宁,黎介寿.加速康复外科护理的概念和临床意义[J].中国实用外科杂志,2007,27(2):131.
[3]李树玲.乳腺肿瘤学[M].第3版.北京:科学技术文献出版社,2007:578-580.
[4] Kehlet H,Wilmore D W. Fast-track surgery[J]. Br J Surg,2005,92(1):3-4.
[5] Kehlet H. Fast-track colorectal surgery[J]. Lancet,2008,371(9615):791-793.
[6]李秀娟.快速康复外科理念在胃肠手术患者围术期护理中的应用[J].解放军护理杂志,2011,28(3):54.
[7] Lawenda BD,Mondry TE,Johnstone PA. Lymphedema:a primer on the identification and management of a chronic condition in oncologic treatment[J]. CA Cancer J Clin,2009,59:8-24.
[8] Stout Gergich NL,Pfalzer LA,Mcgarvey C,et al. Preoperative assessment enables the early diagnosis and successful treatment of lymphedema[J]. Cancer,2008,112:2809-2819.
[9] Meeske KA,Sullivan-Halley J,Smith AW,et al. Risk factors for arm lymphedema following breast cancer diagnosis in black women and white women[J]. Breast Cancer Res Treat,2009,113:383-391.
[10] Bulotiene G,Ostapenko V,Veseliunsa J. Psychological adaptation of breast cancer patients[J]. Acta Medica Lituanica,2006,13(2):92-96.