文章摘要

基于ERAS模式护理在乳腺癌术后同期自体组织乳房重建中的应用

作者: 1许春彦, 1郑立, 2吴俊东, 3李丹樱, 3陈晓红
1 汕头大学医学院附属肿瘤医院放疗二区,广东 汕头 515000
2 汕头大学医学院附属肿瘤医院乳腺中心,广东 汕头 515000
3 汕头大学医学院第一附属医院甲乳外科,广东 汕头 515000
通讯: 陈晓红 Email: cxh88905253@sina.com
DOI: 10.3978/j.issn.2095-6959.2020.05.025
基金: 广东省自然科学基金(2018A030313562,2019A1515010239)。

摘要

目的:探讨加速康复理念(enhanced recovery after surgery,ERAS)在乳腺癌改良根治术后即刻自体组织乳房重建围手术期的应用效果。方法:选择2014年1月至2018年12月收住汕头大学医学院附属肿瘤医院乳腺癌患者实施乳腺癌改良根治术同期自体组织乳房重建56例患者为研究对象,根据随机数字表将患者分为观察组与对照组,每组各28例,对照组围手术期间行常规性护理,观察组围手术期间按多学科结合模式下的快速康复理念实施护理,对比2组患者并发症、康复效果及心理健康情况的差异。结果:2组并发症发生率差异无统计学意义(P>0.05),观察组引流时间、总引流量、自理能力恢复时间、平均住院时间少于对照组(P<0.05),术后24 h舒适度及睡眠质量评分高于对照组(P<0.05)。观察组干预后焦虑抑郁情况评分显著低于对照组(P<0.05)。结论:多学科结合模式下的快速康复理念可加速患者术后康复,提高患者舒适度,降低不良心理问题发生率,提高患者生活质量。
关键词: 乳腺肿瘤;乳腺癌根治术;乳房重建;围手术期;加速康复

Application of enhanced recovery after surgery nursing in perioperative period of breast reconstruction immediately after radical mastectomy

Authors: 1XU Chunyan, 1ZHENG Li, 2WU Jundong, 3LI Danying, 3CHEN Xiaohong
1 Second Department of Radiation Oncology, Affiliated Cancer Hospital of Shantou University Medical College, Shantou Guangdong 515000, China
2 Breast Center, Affiliated Cancer Hospital of Shantou University Medical College, Shantou Guangdong 515000, China
3 Department of Thyroid and Breast Surgery, First Affiliated Hospital of Shantou University Medical College, Shantou Guangdong 515000, China

CorrespondingAuthor: CHEN Xiaohong Email: cxh88905253@sina.com

DOI: 10.3978/j.issn.2095-6959.2020.05.025

Foundation: This work was supported by Guangdong Natural Science Foundation, China (2018A030313562, 2019A1515010239).

Abstract

Objective: To explore the application effect of the concept of Enhanced recovery after surgery (ERAS) in the perioperative period immediately after radical mastectomy. Methods: Fifty-six patients with breast cancer admitted to Affiliated Cancer Hospital of Shantou University Medical College for breast cancer modified radical mastectomy from January 2014 to December 2018 were selected as the study objects. The patients were divided into an observation group and a control group according to the random number table, with 28 patients in each group. The control group received routine nursing during perioperative period, and the observation group received nursing during perioperative period according to the concept of rapid rehabilitation under the model of multidisciplinary combination, and the difference of complications, rehabilitation effect and mental health status between the two groups was compared. Results: There was no significant difference in the incidence of complications between the two groups (P>0.05). The observation group had less drainage time, total drainage volume, recovery time of self-care ability and average length of stay than the control group (P<0.05). The score of anxiety and depression after intervention in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: The concept of rapid rehabilitation under the multidisciplinary mode can accelerate the postoperative rehabilitation of patients, improve the comfort level of patients, reduce the incidence of adverse psychological factors, and improve the quality of life of patients.
Keywords: breast neoplasm; radical mastectomy; breast reconstruction; perioperative period; enhanced recovery after surgery

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