Construction and application of evidence-based practice protocol for early postoperative oral feeding in patients with gastric cancer after gastrectomy
Objective To evaluate the effect of an evidence-based early postoperative oral feeding protocol for patients after gastrectomy.Method According to the"6S"model of the evidence pyramid,we systematically searched for domestic and international expert consensus,systematic evaluation,evidence summaries,and guidelines related to early post-operative oral diet for gastric cancer,and then formulated an evidence-based nursing practice plan in combination with clinical reality.Patients who underwent gastric cancer resection surgery in Daping Hospital were selected,in which 105 patients from January 2020 to April 2021 before the evidence-based nursing practice were the control group,and 141 patients from May 2021 to December 2022 were the evidence-based nursing practice group.The practice group underwent early postoperative transoral dietary intervention,and outcome indicators such as postoperative transoral dietary initiation time,anastomotic leakage/residual leakage,gastric tube retention time,anal gas defecation time,postoperative hospitalisation days and hospitalisation costs were compared between the two groups.Result In the practice group,postoperative transoral diet start time was shortened from 6(3,8)d to 1(1,4)d,gastric tube retention time was shortened from 5(4,7)d to 3(0,4.75)d,anal defecation time was shortened from 4(4,6)d to 3(3,4)d,postoperative bowel movement time was shortened from 5(4,6)d to 4.5(3,5)d,and postoperative hospitalisation days were shortened from 10(9,12)d to 8(7,9)d,and the hospitalisation cost was reduced from ¥74 400(66 600,88 100)to ¥58 600(53 300,69 000),with the differences being statistically significant(P＜0.05);There was no significant difference in postoperative anastomotic leakage/residual leakage(P＞0.05).There was no significant difference in leukocyte count,neutrophil count,lymphocyte count,hemoglobin level and serum albumin level between experimental group and control group(P＞0.05).Conclusion An evidence-based early postoperative oral feeding protocol for gastric cancer after surgery can accelerate the recovery of gastrointestinal function without increasing leakage,but the impact on inflammation and nutritional status during hospitalization is not significant.
Gastric cancerSurgeryEarly oral feedingEvidence based nursing
万方数据
维普
