摘要
目的总结加速康复外科在腹腔镜肝癌切除术围手术期康复护理的应用体会。方法回顾性分析广东省佛山市第一人民医院2014年1月至2015年10月实施腹腔镜肝癌切除术的48例患者的临床资料,遵循加速康复外科的理念,对患者实施规范化加速康复护理,包括术前宣教及心理护理,术前评估和准备,缩短禁食水的时间,使用微创手术,减少或尽量不使用鼻胃管减压,减少引流管放置,术后早期进食、早期活动,运用多模式镇痛充分地术后镇痛,观察患者围手术期护理的效果。结果手术包括左半肝切除6例,右半肝切除6例,左外叶切除20例,左外叶联合左尾叶切除2例,其他肝段或联合肝段切除14例。患者发生术后并发症6例,均经保守治疗后康复出院。术后平均住院时间(8.0±2.3)天,平均住院费用(43 795.6±9 483.2)元。结论腹腔镜肝癌切除术是安全、可行的,并且具有创伤小,恢复快等优势。加速康复护理是手术成功和获得良好疗效的保障。
Objective To generalize peri-operative nursing experience of enhanced recovery after surgery in laparoscopie liver resection for hepatocellular carcinoma. Methods Laparoscopic hepatectomy was performed on 48 hepatocellular carcinoma patients in our department from January 2014 to October 2015. The measures of enhanced recovery after surgery were applied in peri-operative nursing, including pre-operative education and psychotherapy, evaluation and preparation, time-shortening of fasting water, reduction or no-use of naso-gastric tube, reduced placement of unnecessary drainage tubes, post-operative early feeding and activity, multi-mode analgesia. The clinical outcomes of peri-operative nursing were generalized. Results Laparoscopic hepatectomy was performed successfully, including left hemihepatectomy in 6, right hemihepatectomy in 6, left lateral lobectomy or combined caudate lohectomy in 22, and single or combined segmentectomy in 14 cases. Postoperative complications occurred in 6 patients, which recovered after non-surgical treatment. The average postoperative hospital stay was （8.0 ±2.3 ）days, and average hospital charges was （43 795.6±9 483.2） Yuan. Conclusions Application of enhanced recovery after surgery in laparoseopic hepatectomy for hepatocellular carcinoma is safe and feasible with less trauma, quicker recovery, and better clinical effect. Enhanced recovery nursing is safeguard for successful operation and better outcomes.
出处
《消化肿瘤杂志（电子版）》
2015年第4期223-226,共4页
Journal of Digestive Oncology(Electronic Version)
关键词
肝细胞癌
腹腔镜肝切除
护理
围手术期
加速康复
Hepatocellular carcinoma
Laparoscopic liver resection
Nursing
Perioperativeperiod
Enhanced recovery after surgery
