作者：李露露，薛彩云，王红霞

单位：江苏省人民医院 肝胆中心，江苏 南京 210029

Authors:  Li Lulu, Xue Caiyun, Wang Hongxia

Unit:  T Hepatobiliary Center, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu, China

摘要：

目的 研究加速康复外科护理对于肝癌术后下肢静脉血栓的影响。方法选取江苏省人民医院2018年5月到2019年3月收入的112例肝癌手术患者,使用随机数字表法进行分组,分为常规治疗组及加速组,每组56例,常规治疗组给予常规护理,加速组在其基础上加用加速康复护理,比较两组患者术后指标及术后即刻、术后14天心理、疼痛、相关评分及凝血功能相关指标,比较两组患者深静脉血栓形成(deep vein thrombosis DVT)发生率。结果 加速组引流管拔除时间、经口进食时间及住院时间均显著低于常规组,差异具有显著性(P<0.05);护理前两组焦虑自评量表(SAS)、抑郁自评量表(SDS)、疼痛使用视觉模拟评分法(VAS)量表评分差异无统计学意义(P>0.05),护理后加速组SAS、SDS、VAS评分显著低于常规组(P<0.05);护理前两组D-二聚体、纤维蛋白原、纤维蛋白降解产物水平无显著差异,护理后加速组D-二聚体、纤维蛋白原、纤维蛋白降解产物水平及DVT发生率显著低于常规组,差异具有统计学意义(P<0.05)。结论 加速康复护理能有效改善患者心理状态,缓解患者疼痛,降低其机体炎症反应及血液高凝状态,对其术后血栓发生的预防具有促进作用。

关键词：  加速康复; 护理; 肝癌; 下肢静脉血栓

Abstract：

Objective To study the effect of accelerated rehabilitation surgical nursing on lower limb venous thrombosis after liver cancer surgery. Methods A total of 112 patients with liver cancer who were admitted to our hospital from May 2018 to March 2019 were selected and divided into two groups using the random number table method. They were divided into the conventional treatment group and the accelerated group, with 56 cases in each group. The conventional treatment group was given routine care. In the acceleration group, accelerated rehabilitation nursing was added on the basis of this. The postoperative indicators and the psychological, pain, related scores and coagulation function related indicators of the two groups were compared immediately after operation, and the deep vein thrombosis (DVT). Results The drainage tube removal time, oral feeding time and hospitalization time in the acceleration group were significantly lower than those in the conventional group, and the differences were significant (P<0.05). There was no significant difference in SAS, SDS, and VAS scores between the two groups before nursing (P <0.05). >0.05), the SAS, SDS, and VAS scores in the accelerated group were significantly lower than those in the conventional group (P<0.05); there was no significant difference in DD, FIB, FID levels between the two groups before nursing, and DD, FIB, FDP levels and DVT incidence in the accelerated group after nursing It was significantly lower than the conventional group, and the difference was statistically significant (P<0.05). Conclusion Accelerated rehabilitation nursing can effectively improve the patient's psychological state, relieve pain, reduce the body's inflammatory response and blood hypercoagulability, and it can promote the prevention of postoperative thrombosis.

Key Words:  Accelerated rehabilitation; Nursing; Liver cancer; Venous thrombosis