摘要
目的:探讨结肠癌术后并发腹腔感染的内质网应激机制及其对肠道护理的启示。方法:采用蛋白免疫印迹检测体外培养人肠上皮Caco-2细胞株中内质网应激相关蛋白转录因子C/EBP同源蛋白(C/EBP homologous protein,CHOP)的表达;实时荧光定量聚合酶链式反应检测肠道紧密连接蛋白膜周蛋白(zonula occludens,ZO)信使核糖核酸(messenger Ribonucleic Acid,m RNA)的表达水平;选取2017年10月—2020年10月在南京医科大学附属南京医院普外科诊治的56例结肠癌术后并发腹腔感染的病人为研究对象,观察组28例,给予基于循证支持的氧气吸入术和局部氧疗为主的护理干预;对照组28例,给予常规护理干预。检测两组病人血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)水平,观察两组并发症、焦虑、抑郁发生率及护理满意度。结果:常氧条件下,体外培养的Caco-2细胞中ZO-1及CHOP的表达与缺氧条件下表达进行比较,差异有统计学意义(均P<0.05或P<0.01);护理干预后,观察组CRP、TNF-α和IL-6与对照组比较,差异均有统计学意义(均P<0.001);腹腔感染、肠梗阻、吻合口漏和并发症总发生率与对照组比较,差异有统计学意义(均P<0.05);焦虑、抑郁发生率及护理满意度与对照组比较,差异具有统计学意义(P<0.05)。结论:基于循证支持的护理干预有助于减少结肠癌术后并发腹腔感染病人的并发症,缓解焦虑、抑郁等负性情绪。
Objective:To investigate the endoplasmic reticulum stress mechanism of intra-abdominal infection after colon cancer surgery and its enlightenment for intestinal nursing.Methods:Western blot was used to detect the expression of endoplasmic reticulum stressrelated protein CHOP in human intestinal epithelial Caco-2 cells cultured in vitro;the expression level of intestinal tight junction protein ZO-1 m RNA was detected by real-time fluorescence quantitative PCR.A total of 56 patients with postoperative intra-abdominal infection after colon cancer diagnosed and treated in the General Surgery Department of Nanjing Hospital Affiliated to Nanjing Medical University from October 2017 to October 2020 were divided into the observation group and the control group,28 cases in each.The observation group received evidence-based oxygen inhalation and local oxygen therapy as the main nursing intervention;the control group received the routine nursing intervention.The two groups’ serum levels of C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α),and interleukin 6(IL-6)were detected,and the incidence of complications,anxiety,depression,and nursing satisfaction were observed.Results:Under normoxia,the expressions of ZO-1 and CHOP in Caco-2 cells cultured in vitro were compared with those under hypoxia,and the difference was statistically significant(both P<0.05 or P<0.01).After the nursing intervention,the difference of CRP,TNF-α,and IL-6 in the observation group was statistically significant compared with the control group(all P<0.001).Compared with the control group,the total incidence of abdominal infection,intestinal obstruction,anastomotic leakage,and complications in the observation group were significantly statistically different(all P<0.05).The incidence of anxiety,depression,and nursing satisfaction were significantly statistically different from those in the control group(P<0.05).Conclusions:Nursing intervention based on evidence-based support could help reduce the complications of patients with intra-abdominal infection after colon cancer surgery and relieve negative emotions such as anxiety and depression.
作者
朱梦媛
张莉
ZHU Mengyuan;ZHANG Li(Nanjing Hospital Affiliated to Nanjing Medical University,Jiangsu 210006 China)
出处
《护理研究》
北大核心
2022年第4期635-639,共5页
Chinese Nursing Research
基金
国家自然科学基金项目,编号:81571437。
关键词
结肠癌
腹腔感染
内质网
应激
作用机制
并发症
肠道护理
colon cancer
abdominal infection
endoplasmic reticulum
stress
mechanism of action
complications
intestinal care
