作者：徐梅芳，庄素敏，黄锦青，黄家荣，缪锦超，庄海静，陈清銮，曾楚梵，叶苏丽，马丹丹，陈丽

单位：广东省汕尾市海丰县彭湃纪念医院 普通外科，广东 海丰 516400

Authors:  Xu Meifang, Zhuang Sumin, Huang Jinqing, Huang Jiarong, Miao Jinchao, Zhuang Haijing, Chen Qingluan, Ceng Chufan, Ye Suli, Ma Dandan, Chen Li

Unit:  Department of General Surgery, Pen-pai Memorial Hospital, Haifeng 516400, Guangdong, China

摘要：

目的  比较微信公众号及常规护理宣教在加速康复外科模式下结直肠癌手术后出院患者延续护理的效果。方法  将广东省汕尾市海丰县彭湃纪念医院普通外科2018年1月至2020年1月收治并手术的结直肠癌患者124例,随机分为观察组和对照组,每组患者62例。对照组患者进行常规健康宣教,观察组在常规宣教的基础上联合基于微信公众号的延续性护理模式。收集两组患者的一般资料、中文版延续护理测评量表,比较两组患者术后4周自我护理能力以及术后并发症发生情况,以及结直肠癌患者生命质量测定量表评分及对延续护理服务满意度。结果  干预前,两组患者中文版延续护理测评量表各因子差异均无统计学意义。干预后,因子1观察组得分(67.2±18.1)分,对照组(58.5±18.2)分,差异有统计学意义(P<0.05);因子2观察组得分(36.5±3.6)分,对照组(38.2±5.6)分,差异有统计学意义(P<0.05);因子3观察组得分(37.3±8.5)分,对照组(47.4±11.1)分,差异有统计学意义(P<0.05);因子4观察组得分(80.3±13.4)分,对照组(66.9±18.1)分,差异有统计学意义(P<0.05)。两组患者出院后并发症发生率比较,观察组4.3%,对照组6.2%,差异有统计学意义(P<0.05);结直肠癌患者生命质量测定量表,观察组得分(88.9±4.1)分,对照组(66.8±18.8)分,差异有统计学意义(P<0.05);延续护理服务满意度观察组99.6 %,对照组93.5%,差异有统计学意义(P<0.05)。结论  对加速康复外科模式下结直肠癌患者使用微信公众号平台实施延续护理服务,有助于降低术后并发症发生率,提高患者对延续护理服务满意度,改善生活质量。

关键词：  微信; 加速康复外科; 结直肠癌; 延续护理

Abstract：

Objective Comparing the effects of WeChat-based multimodal nursing program and conventional nursing program in the continuation of nursing care of patients with colorectal cancer after enhanced recovery after surgery. Methods One hundred twenty four patients with colorectal cancer who were admitted and operated in our department from January 2018 to January 2020 were randomly divided into observation group and control group, with 62 patients in each group. Patients in the control group were given regular health education, and the observation group was combined with a WeChat-based multimodal nursing program on the basis of routine education. Collect the general information of the two groups of patients, the Chinese version of the continuous care assessment scale, compare the self-care ability of the two groups of patients three months after surgery and the occurrence of postoperative complications, the quality-of-life measurement scale for colorectal cancer patients and the continuous care service Satisfaction, analyze and compare the two sets of data. Results Before the intervention, there was no statistically significant difference in factors between the two groups of patients in the Chinese version of the Continuing Nursing Assessment Scale. After intervention, factor 1, observation group scored (67.2±18.1), control group (58.5±18.2); factor 2, observation group scored(36.5±3.6), control group(38.2±5.6); factor 3, observation group scored(37.3±8.5), control group(47.4±11.1); factor (P＜0.05). The incidence of complications after discharge in observation group was 4.3%, while 6.2% in control group, the difference was statistically significant(P＜0.05). For the quality-of-life measurement scale for colorectal cancer patients, the observation group scored(88.9±4.1), and the control group(66.8±18.8), the difference was statistically significant(P＜0.05). For the continuous nursing service satisfaction, observation group was 99.6%, while 93.5% in control group, all difference was statistically significant. Conclusion The use of the WeChat based multimodal nursing program to implement continuation care services for colorectal cancer patients after enhanced recovery after surgery can reduce the incidence of postoperative complications, and improve patients’satisfaction with continuation care services, it is worthy of clinical application.

Key Words:  WeChat; Enhanced recovery after surgery; Colorectal cancer; Continued care