查看更多>>摘要：目的 探讨消化道肿瘤患者手术后强化落实超声药物渗透治疗的护理干预对患者术后快速康复的影响，为消化道肿瘤患者术后快速康复干预方案的制订提供参考。 方法 采用随机对照试验方法，于2021年4—7月，选择大连医科大学附属第二医院收治的消化道肿瘤术后患者120例为研究对象，按照随机数字表法分为对照组、分散治疗组以及集中治疗组，每组40例。对照组主要采用常规加速康复外科护理，并辅以早期康复训练；分散治疗组在对照组的基础上接受了超声药物渗透治疗的护理干预，每天上午和下午各进行1次，每次持续30 min；集中治疗组在对照组的基础上采取了一次性60 min的超声药物渗透治疗的护理干预。采用单因素方差分析、LSD-t检验和χ2检验比较各组患者的胃肠道反应、肠道功能恢复情况、住院情况、术后并发症及护理满意度。 结果 对照组男27例，女13例，年龄（61.85 ± 16.85）岁；分散治疗组男23例，女17例，年龄（60.90 ± 16.88）岁；集中治疗组男23例，女17例，年龄（59.80 ± 13.58）岁。分散治疗组和集中治疗组患者术后恶心、呕吐及腹胀症状持续时间、肠鸣音恢复时间、排气恢复时间及首次进食时间分别为（38.58 ± 2.74）、（17.45 ± 1.92）、（38.76 ± 3.34）、（50.04 ± 2.57） h和（36.79 ± 2.58）、（16.48 ± 1.85）、（36.98 ± 2.28）、（48.25 ± 3.07） h，均低于对照组的（43.13 ± 3.56）、（21.24 ± 2.50）、（42.65 ± 3.78）、（52.21 ± 3.15） h，差异均有统计学意义（t值为3.38～9.68，均P<0.05）；集中治疗组患者术后恶心、呕吐及腹胀症状持续时间、肠鸣音恢复时间、排气恢复时间及首次进食时间短于分散治疗组，差异均有统计学意义（t值为2.31～3.01，均P<0.05）。分散治疗组和集中治疗组患者下床活动时间、住院时间分别为（5.83 ± 1.20） h、（9.90 ± 2.12） d和（7.35 ± 2.13） h、（8.30 ± 1.42） d，对照组分别为（4.39 ± 1.53） h、（14.93 ± 2.56） d，分散治疗组和集中治疗组患者下床活动时间、住院时间优于对照组，集中治疗组患者下床活动时间、住院时间优于分散治疗组，差异均有统计学意义（t值为-7.14～14.34，均P<0.05）。对照组术后肠梗阻的发生率为15.0%（6/40），而分散治疗组为5.0%（2/40），集中治疗组为0，差异有统计学意义（χ2=7.50，P<0.05）。集中治疗组患者护理满意度达到了100.00%（40/40），分散治疗组和对照组分别为92.5%（37/40）和85.0%（34/40），差异有统计学意义（χ2=6.49，P<0.05）。 结论 经过超声药物渗透治疗的护理干预，尤其是集中治疗方式的护理干预，可以显著改善消化道肿瘤患者术后肠道功能，减轻术后胃肠道反应，缩短住院时间，减少术后并发症的发生，加快患者康复，为临床提供有效的护理干预方案，值得推广应用。 Objective To explore the impact of nursing intervention in strengthening the implementation of ultrasound drug penetration therapy on postoperative rapid recovery of patients with digestive tract tumors after surgery, and to provide reference for the formulation of intervention plans for postoperative rapid recovery of digestive tract tumor patients. Methods A randomized controlled trial was used. From April to July 2021, 120 postoperative patients with digestive tract tumors admitted to the Second Affiliated Hospital of Dalian Medical University were selected and divided into a control group, a dispersed treatment group, and a concentrated treatment group according to the random number table method, with 40 patients in each group. The control group mainly received routine accelerated rehabilitation surgical care, supplemented by early rehabilitation training the dispersed treatment group received nursing intervention with ultrasound drug penetration therapy on the basis of the control group, once a day in the morning and once in the afternoon, lasting for 30 min each time on the basis of the control group, the concentrated treatment group received nursing intervention of one-time concentrated ultrasound drug penetration therapy for 60 min. The gastrointestinal reactions, intestinal function recovery, hospitalization, postoperative complications, and nursing satisfaction of each group of patients were observed and compared using one-way ANOVA, LSD-t test, and χ2 test. Results There were 27 males and 13 females in the control group, aged (61.85 ± 16.85) years old. while 23 males and 17 females in the dispersed treatment group aged (60.90 ± 16.88) years old, and 23 males and 17 females in the concentrated treatment group aged (59.80 ± 13.58) years old. The duration of postoperative nausea, vomiting, and abdominal distension symptoms, recovery time of bowel sounds, recovery time of exhaust, and first meal time in the dispersed treatment group and concentrated treatment group were (38.58 ± 2.74), (17.45 ± 1.92), (38.76 ± 3.34), (50.04 ± 2.57) h and (36.79 ± 2.58), (16.48 ± 1.85), (36.98 ± 2.28), (48.25 ± 3.07) h, respectively, which were lower than those in the control group (43.13 ± 3.56), (21.24 ± 2.50) (42.65 ± 3.78), (52.21 ± 3.15) h, the differences were statistically significant (t values were 3.38-9.68, all P<0.05). The duration of postoperative nausea, vomiting, and abdominal distension symptoms, recovery time of bowel sounds, recovery time of exhaust, and first meal time in the concentrated treatment group were shorter than those in the dispersed treatment group, and the differences were statistically significant (t values were 2.31-3.01, all P<0.05). The time to get out of bed activity and hospitalization of patients in the dispersed treatment group and the concentrated treatment group were (5.83 ± 1.20) h, (9.90 ± 2.12) d and (7.35 ± 2.13) h, (8.30 ± 1.42) d, respectively. The control group was (4.39 ± 1.53) h and (14.93 ± 2.56) d, respectively. The time to get out of bed activity and hospitalization of patients in the dispersed treatment group and the concentrated treatment group were better than those in the control group, while the time to get out of bed activity and hospitalization of patients in the concentrated treatment group were better than those in the dispersed treatment group, the differences were statistically significant (t values were -7.14-14.34, all P<0.05). The incidence of intestinal obstruction was 15.0% (6/40) in the control group, 5.0% (2/40) in the dispersed treatment group, and 0 in the concentrated treatment group, with a statistically significant difference (χ2=7.50, P<0.05). The nursing satisfaction of patients in the concentrated treatment group reached 100.00% (40/40), which was 92.5% (37/40) and 85.0% (34/40) in the dispersed treatment group and control group, with a statistically significant difference (χ2=6.49, P<0.05). Conclusions Nursing intervention through ultrasound drug penetration therapy, especially centralized treatment, can significantly improve postoperative intestinal function, reduce postoperative gastrointestinal reactions, shorten hospitalization time, reduce postoperative complications, accelerate patient recovery, and provide effective nursing intervention plans for clinical practice. It is worth promoting and applying.
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