综合护理干预在达芬奇机器人手术系统治疗原发性肝癌伴肝硬化患者术后护理中的应用

摘要

目的:探讨综合护理干预在达芬奇机器人手术系统(DVSS)治疗伴肝硬化的原发性肝癌患者术后护理中的应用价值.方法:以2016年6月 ～2017年9月我院收治的50例原发性肝癌伴肝硬化患者为研究对象,患者均接受DVSS术治疗,采用随机数字表法将其等分为对照组和观察组,对照组术后实施常规护理,观察组在此基础上采用综合护理干预,观察两组术后肛门排气时间、排便时间、术后住院时间、术后C反应蛋白(CRP)变化;采用丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBiL)评估两组肝功能恢复情况;比较两组术后并发症发生情况.结果:观察组术后肛门排气时间、排便时间、住院时间较对照组短,差异有统计学意义(P<0.05);术后第1,3 d两组CRP较术前明显升高,术后6 d两组CRP有明显下降趋势,但观察组术后1,3,6 d CRP水平均明显低于对照组(P<0.05);与护理干预前相比较,护理干预后两组ALT,AST,TBiL明显降低,但观察组的降低较对照组明显(P<0.05);观察组术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05).结论:综合护理干预在DVSS术治疗原发性肝癌伴肝硬化患者术后护理中有推广应用优势.%Objective: To explore the application value of comprehensive nursing intervention on patients with primary hepatic carcinoma accompanying liver cirrhosis cured by Da Vinci surgical system (DVSS) in postoperative nursing. Methods: To select 50 cases of patients with primary hepatic carcinoma ac-companying liver cirrhosis cured in our hospital from June 2016 to September 2017 as research objectives, divide them into control group and observation group by table of random number. Patients in control group were given regular nursing after having operation, while patients in observation group were given comprehensive nursing intervention on the basis of regular nursing. Observe the time of farting from anus, time of defecating, duration of hospitalization after operation, changes of c - reactive protein (CRP) between the two groups after operation; evaluate the recovering situation of hepatic function by alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBiL) between the two groups; compare the postoperative complications between the two groups. Results: Time of postoperative farting from anus, time of defecating, duration of hospitalization of observation group was shorter than that of control group. Difference was statistically significant(P < 0. 05). The CRP of two groups in the first and third day after operation were higher than that be-fore operation, the CPR of two groups in the sixth day after operation were decreased, but CPR level of observation group in the first, third and sixth day af-ter operation were obviously lower than that of control group(P < 0. 05); the ALT, AST, and TBiL of two groups were reduced obviously after the nursing intervention comparing to that before the nursing intervention, but the effect on observation group was more obvious than that of control group(P < 0. 05);postoperative complication of observation group was obviously lower than that of control group. Difference was statistically significant(P < 0. 05). Conclu-sion: It was founded that comprehensive nursing intervention had the advantage of application and popularization on patients with primary hepatic carcinoma accompanying liver cirrhosis cured by DVSS in postoperative nursing.