谢张黄　谢小冬　蔡一波

[摘要] 目的 探讨腹腔镜结直肠癌根治术的手术室整体护理及配合情况。 方法 选取我院2013年1月～2014年1月行腹腔镜结直肠癌根治术患者80例临床资料进行分析依据护理措施不同进行临床分组：干预组40例，对照组40例，对照组实施随机对症护理，干预组实施围术期整体护理，包括术前、术中及术后护理，比较两组SAS评分的变化情况、两组患者的SBP、DBP、HR的变化情况以及两组术后肛门排气时间、术后下床活动时间、引流管拔出时间、术后疼痛率情况。 结果 入院时两组SAS评分组间比较无明显差异（t=0.934、4.48，P>0.05），干预后干预组的SAS评分（32.0±5.6）分，显著低于对照组的（45.3±7.0）分，组间比较差异均有统计学意义（t=6.237，P<0.05）。干预组患者的SBP、DBP、HR干预后与入院时比较无显著变化，而对照组患者的SBP、DBP、HR干预后与入院时比较，差异均有统计学意义（P<0.05）。干预组患者的SBP、DBP、HR干预后与对照组比较，差异均有统计学意义（P<0.05）。干预组患者术后肛门排气时间、术后下床活动时间、引流管拔出时间均短于对照组，组间比较差异有统计学意义（P<0.05）。且干预组患者术后疼痛率均显著低于对照组，组间比较差异有统计学意义（P<0.05）。 结论 手术室护理人员将整体护理应用于腹腔镜结直肠癌根治术同时密切配合，有利于缓解患者的焦虑情绪、保持生命体征的稳定，有利于提高围术期的护理质量，促进患者术后恢复。

[关键词] 腹腔镜结直肠癌根治术；手术室；整体护理；SAS评分

[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2015）04-0148-04

[Abstract] Objective To explore the laparoscopic radical resection of rectal carcinoma of holistic nursing care in operation room and cope with the situation. Methods In our hospital from January 2013 to January 2014， the clinical data of 80 cases with laparoscopic resection of colorectal cancer were analyzed，they were divided into two groups： intervention group of 40 cases， control group of 40 cases according to different nursing measures， control group treated with implement random symptomatic care， the intervention group treated with the perioperative holistic nursing， including nursing before operation， during operation and after the operation， SAS score， SBP， DBP， HR， anal exhaust time， postoperative ambulation time， drainage tube extubation time， postoperative pain rate were compared between two groups. Results The SAS score between two groups had no significant difference（t=0.934， 4.48， P>0.05）， the SAS score of the intervention group was （32.0±5.6）scores， was significantly lower than the control group （45.3±7.0） scores， the differences between two groups were statistically significant （t=6.237， P<0.05）. The SBP， DBP， HR of intervention group had no significant change at the time of admission and compared with prognosis of stem， while the SBP， DBP， HR of control group after the intervention compared with the time of admission，the differences were statistically significant （P<0.05）. The SBP， DBP， HR in the intervention group after the intervention compared with the control group， the difference was statistically significant（P<0.05）. Anal exhaust time， postoperative ambulation time， drainage tube pulled out of time of patients in the intervention group were shorter than the control group， there were statistically significant differences between two groups（P<0.05）. And the patients in the intervention group after the pain were significantly lower than those in the control group， there were statistically significant differences between two groups （P<0.05）. Conclusion Operation room nursing personnel will be applied to the whole nursing of laparoscopic resection of colorectal cancer and close coordination， can help to alleviate anxiety and maintain vital signs in patients with stable， is conducive to improve the quality of nursing care in perioperative period of patients， promote the postoperative recovery.

[Key words] Laparoscopic radical resection of colorectal cancer； Operation room； Holistic nursing； SAS score

腹腔镜结直肠癌根治术具有手术创伤小、患者疼痛轻和术后恢复时间快、并发症少、住院时间短等优点，对于实施腹腔镜结直肠癌根治术的患者同时配合严密的手术室护理，才能确保手术的顺利进行，从而提高治疗效果。手术室护士不仅要了解手术方案，了解手术的过程与步骤，还要能熟练掌握各种器械的名称、用途等，根据患者情况准备器械，从而更好地协助医师顺利完成手术，保证安全和高效的手术。随着医学模式的转变，护理工作也由过去的以疾病为中心的功能制护理转变为以患者为中心的整体护理[1]。将手术室整体护理应用于腹腔镜结直肠癌根治术的护理……