作者：李敦穹1，李敦旭2

单位：1. 海南省海口市人民医院 肛肠科，海南 海口 570206； 2. 海南省海口市人民医院 胃肠外科，海南 海口 570206

Authors:  Li Dunqiong1，Li Dunxu2

Unit:  1.Department of Anorectal Surgery, Haikou People's Hospital, Haikou 570206, Hainan, China； 2.Department of Gastroenterology Surgery, Haikou People's Hospital, Haikou 570206, Hainan, China

摘要：

目的  探讨饮食联合心理护理在胃癌根治性全胃切除术中的应用价值及对患者远期营养状态的影响。方法  选取2014年5月～2015年10月收治的行胃癌根治性全胃切除术患者共49例,采用随机数字表法分为两组,实验组24例,对照组25例。所有患者术后均接受常规护理管理,包括预防感染、监测生命体征、评估病情改善等,实验组在此基础上增加饮食联合心理护理,观察并比较两组护理干预效果,分析患者远期营养状态。结果  49例患者均顺利完成手术,术后部分患者发生并发症,处理后有效控制;术后实验组通气时间与对照组比较无明显差异(P>0.05),但排便时间、进流质时间、进半流质时间和术后住院时间均短于对照组(P<0.05);两组术后短期体质改善及营养指标变化比较无明显差异(P>0.05),但术后12月实验组患者BMI水平、上臂围度、皮褶厚度及前清蛋白、清蛋白水平均优于对照组(P<0.05);术后实验组情绪状态改善优于对照组(P<0.05)。结论  对胃癌全切术患者开展加强饮食联合心理护理能有效促进术后恢复,改善机体营养状态和负面情绪,对提高患者预后质量有重要意义,值得推广。

关键词： 饮食护理; 心理护理; 胃癌全切术; 营养状态

Abstract：

Objective  To explore the application value of diet combined with psychological nursing in total gastrectomy for gastric cancer and its effect on long-term nutritional status of patients. Methods  A total of 49 patients with gastric cancer who underwent total gastrectomy from May 2014 to October 2015 were selected and divided into two groups according to the time of consultation, 24 in the experimental group and 25 in the control group. All patients received routine nursing management after operation, including prevention of infection, monitoring vital signs, evaluation of improvement of the condition, etc. On this basis, the experimental group added diet combined with psychological nursing, observed and compared the effect of nursing intervention between the two groups, and analyzed the long-term nutritional status of patients. Result  All the 49 patients successfully completed the operation, and some patients had complications after operation, which were effectively controlled after treatment. There was no significant difference in ventilation time between the experimental group and the control group (P>0.05), but defecation time, fluids time, half fluids time and hospitalization time after operation were shorter than those of the control group (P<0.05). There was no significant difference (P>0.05), but BMI level, upper arm circumference, skin fold thickness, prealbumin and albumin levels in the experimental group were better than those in the control group in 12 months after operation (P<0.05), and the improvement of emotional state in the experimental group was better than that in the control group (P<0.05). Conclusion  Enhanced diet combined with psychological nursing can effectively promote the recovery of patients after total gastrectomy, improve the nutritional status and negative emotions of the body, and improve the prognosis quality of patients with gastric cancer. It is worth promoting.

Key Words:  Dietary nursing; Psychological nursing; Total gastrectomy for gastric cancer; Nutritional status