万红+董艳红+高军

[摘要] 目的 探讨减少高龄卵巢癌患者术后胃肠胀气的早期干预效果。 方法 选取52例高龄卵巢癌手术病例，随机分成干预组和对照组；对照组接受术后常规护理，干预组同时行促进胃肠功能恢复的早期干预措施；比较术后肠鸣音恢复时间，肛门恢复排气时间，血清胃动素浓度，胃肠胀气发生率及生活质量情况。 结果 干预组肠鸣音恢复时间、肛门恢复排气时间、胃肠胀气发生率分别为（28.4±7.2）h、（35.1±6.7）h和23.1%，均小于对照组（P<0.05）；干预组和对照组术后24 h胃动素浓度分别为（162.5±47.3）pg/mL、（151.7±44.8）pg/mL，均低于术前，而术后72 h均较24 h升高，且干预组高于对照组[（228.5±67.3）pg/mL vs （175.1±54.6）pg/mL，P<0.05）；术后干预组生活质量总分高于对照组（P<0.05）。结论 早期干预能显著改善高龄卵巢癌术后胃肠胀气的发生，促进胃肠功能恢复，提高患者生活质量。

[关键词] 卵巢肿瘤；高龄患者；胃肠胀气；早期；护理干预

[中图分类号] R737.31；R473.71 [文献标识码] B [文章编号] 1673-9701（2015）25-0129-03

Effect of early intervention on postoperative flatulence of elderly patients with ovarian cancer

WAN Hong1 DONG Yanhong1 GAO Jun2

1.Obstetrics and Gynecology Department，the People's Hospital of Lean County in Jiangxi Provice， Lean 344300， China；2.Department Gynecology， Jiangxi Provincial People's Hospital， Nanchang 330006， China

[Abstract] Objective To investigate the effect of early intervention on reduce postoperative flatulence of elderly patients with ovarian cancer. Methods A total of 52 cases of elderly ovarian cancer treated by surgery were involved， which were randomly divided into intervention and control group. The intervention measures to promote gastrointestinal function recovery were received in intervention group， while only postoperative routine nursing measures were received in control group. Recovery time of bowel sound， restoration of anal exhaust time， serum motilin levels， flatulence occurred rate and quality of life were compared between two groups. Results Recovery time of bowel sound， restoration of anal exhaust and flatulence occurred rate were（28.4±7.2）h， （35.1±6.7）h and 23.1% in intervention group respectively， were lower than those in control group（P<0.05）. The motilin levels of postoperative 24 h were （162.5±47.3）pg/mL and （151.7±44.8）pg/mL in intervention and control group respectively， were lower than those in preoperative. The motilin levels in postoperative 72 h was higher than in postoperative 24 h， and the levels in intervention group was higher than that in control group[（228.5±67.3） pg/mL vs（175.1±54.6） pg/mL， P<0.05）. The postoperative quality of life in intervention group was higher than that in control group（P<0.05）. Conclusion Early intervention can reduce postoperative flatulence of elderly patients with ovarian cancer， promote the recovery of gastrointestinal function， improve the quality of life of the patients.

[Key words] Ovarian cancer； Elderly patients； Flatulence； Early； Nursing intervention

卵巢癌是女性生殖系统中死亡率最高的恶性肿瘤，其发病随年龄增加，好发于60～70岁妇女，中位年龄为63岁。手术效果是影响卵巢癌总生存率的决定性因素[1]。经腹手术后易出现胃肠胀气等不适，严重时可诱发呼吸困难、下腔静脉血液回流障碍、腹壁切口愈合不良、肠粘连等[2]；且高龄患者由于身体功能在不断减弱，胃肠道顺应能力差，术后更易出现胃肠胀气，进而引起一系列的并发症，严重影响术后康复及生活质量[3]。采取有效的护理管理及早期干预手段，减少术后胃肠胀气的发生，具有重要的意义。本研究在临床上采取早期干预，可有效地减少高龄卵巢癌患者术后胃肠胀气的发生，现报道如下。

1 资料与方法

1.1 临床资料

选择2011年9月～2015年5月在江西省人民医院行经腹手术的52例上皮性卵巢癌（epithelial ovarian cancer，EOC）病例，年龄60～72岁（中位65.6岁）。采用随机数字表法将其分为干预组和对照组，各26例，两组年龄、文化、手术病理分期、组织学类型、分化程度等比较差异无统计学意义（P>0.05）。……