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加速康复外科精准护理在结直肠癌围术期的应用及效果评价
OBJECTIVE: To examine the effect of perioperative precision nursing care of enhanced recovery after surgery (ERAS) on the postoperative recovery, stress response, and psychological state of colorectal cancer patients. METHODS: A total of 100 patients undergoing elective laparoscopic colorectal cance...
Formato: | Online Artículo Texto |
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Lenguaje: | English |
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四川大学学报(医学版)编辑部
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442614/ https://www.ncbi.nlm.nih.gov/pubmed/37545068 http://dx.doi.org/10.12182/20230760505 |
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collection | PubMed |
description | OBJECTIVE: To examine the effect of perioperative precision nursing care of enhanced recovery after surgery (ERAS) on the postoperative recovery, stress response, and psychological state of colorectal cancer patients. METHODS: A total of 100 patients undergoing elective laparoscopic colorectal cancer surgery were randomly assigned to an experimental group and a control group, with 50 patients in each group. The experimental group received systematic, standardized, and specialized precision nursing care in three stages, the preoperative, intraoperative, and postoperative stages, while the control group received routine nursing care. The main outcome indicators compared between the two groups included the time of the first postoperative passage of flatus and stool, ambulation, liquid-diet meal, postoperative length-of-stay, and C-reactive protein (CRP), interleukin-6 (IL-6), and homeostatic model assessment of insulin resistance (HOMR-IR) measured 1 day before surgery and 1, 3, and 5 days after surgery. Secondary outcome indicators included the anxiety and depression levels of patients measured upon admission to the hospital and 48 h after surgery by Self-rating Anxiety Scale (SAS) and Self-rating Sepression Scale (SDS), respectively. RESULTS: In the experimental group, the time of the first postoperative passage of flatus and stool, ambulation, and liquid-diet meal and the postoperative length-of-stay were all lower than those in the control group. The postoperative CRP and IL-6 levels of the two groups were significantly higher than the preoperative levels, and the control group had higher CRP and IL-6 levels than the experimental group did, all showing significant difference (P<0.05). The two groups presented different stress states at different points of time after surgery, with the CRP and IL-6 levels reaching the highest 3 days after surgery and then dropping to some degree afterwards. The HOMR-IR of the patients in the experimental group was significantly lower than that of the control group and the difference was significant at both 1 d and 3 d after surgery (P<0.05). Comparison of the difference in the anxiety and the depression scores in the two groups showed significant difference (P<0.05). Before discharge, patient satisfaction of the experimental group was significantly higher than that of the control group (P<0.05). CONCLUSION: The implementation of ERAS precision nursing care can effectively promote the postoperative recovery of colorectal cancer patients, reduce the perioperative stress response, alleviate anxiety and depression, improve patient satisfaction, and hence should be extensively applied in clinical practice. |
format | Online Article Text |
id | pubmed-10442614 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | 四川大学学报(医学版)编辑部 |
record_format | MEDLINE/PubMed |
spelling | pubmed-104426142023-08-28 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 Sichuan Da Xue Xue Bao Yi Xue Ban 加速康复外科精准护理 OBJECTIVE: To examine the effect of perioperative precision nursing care of enhanced recovery after surgery (ERAS) on the postoperative recovery, stress response, and psychological state of colorectal cancer patients. METHODS: A total of 100 patients undergoing elective laparoscopic colorectal cancer surgery were randomly assigned to an experimental group and a control group, with 50 patients in each group. The experimental group received systematic, standardized, and specialized precision nursing care in three stages, the preoperative, intraoperative, and postoperative stages, while the control group received routine nursing care. The main outcome indicators compared between the two groups included the time of the first postoperative passage of flatus and stool, ambulation, liquid-diet meal, postoperative length-of-stay, and C-reactive protein (CRP), interleukin-6 (IL-6), and homeostatic model assessment of insulin resistance (HOMR-IR) measured 1 day before surgery and 1, 3, and 5 days after surgery. Secondary outcome indicators included the anxiety and depression levels of patients measured upon admission to the hospital and 48 h after surgery by Self-rating Anxiety Scale (SAS) and Self-rating Sepression Scale (SDS), respectively. RESULTS: In the experimental group, the time of the first postoperative passage of flatus and stool, ambulation, and liquid-diet meal and the postoperative length-of-stay were all lower than those in the control group. The postoperative CRP and IL-6 levels of the two groups were significantly higher than the preoperative levels, and the control group had higher CRP and IL-6 levels than the experimental group did, all showing significant difference (P<0.05). The two groups presented different stress states at different points of time after surgery, with the CRP and IL-6 levels reaching the highest 3 days after surgery and then dropping to some degree afterwards. The HOMR-IR of the patients in the experimental group was significantly lower than that of the control group and the difference was significant at both 1 d and 3 d after surgery (P<0.05). Comparison of the difference in the anxiety and the depression scores in the two groups showed significant difference (P<0.05). Before discharge, patient satisfaction of the experimental group was significantly higher than that of the control group (P<0.05). CONCLUSION: The implementation of ERAS precision nursing care can effectively promote the postoperative recovery of colorectal cancer patients, reduce the perioperative stress response, alleviate anxiety and depression, improve patient satisfaction, and hence should be extensively applied in clinical practice. 四川大学学报(医学版)编辑部 2023-07-20 /pmc/articles/PMC10442614/ /pubmed/37545068 http://dx.doi.org/10.12182/20230760505 Text en © 2023《四川大学学报(医学版)》编辑部 版权所有 https://creativecommons.org/licenses/by-nc/4.0/开放获取 本文遵循知识共享署名—非商业性使用4.0国际许可协议(CC BY-NC 4.0),允许第三方对本刊发表的论文自由共享(即在任何媒介以任何形式复制、发行原文)、演绎(即修改、转换或以原文为基础进行创作),必须给出适当的署名,提供指向本文许可协议的链接,同时标明是否对原文作了修改;不得将本文用于商业目的。CC BY-NC 4.0许可协议详情请访问 https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (CC BY-NC 4.0). In other words, the full-text content of the journal is made freely available for third-party users to copy and redistribute in any medium or format, and to remix, transform, and build upon the content of the journal. You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may not use the content of the journal for commercial purposes. For more information about the license, visit https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 加速康复外科精准护理 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 |
title | 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 |
title_full | 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 |
title_fullStr | 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 |
title_full_unstemmed | 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 |
title_short | 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 |
title_sort | 加速康复外科精准护理在结直肠癌围术期的应用及效果评价 |
topic | 加速康复外科精准护理 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442614/ https://www.ncbi.nlm.nih.gov/pubmed/37545068 http://dx.doi.org/10.12182/20230760505 |
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