单君　赵逸斌

[摘要] 目的 探討康复训练结合体位干预护理对腹腔镜结肠癌患者术后胃肠功能与并发症的影响。 方法 选择我院于2013年10月～2015年10月期间接收的被确诊为结肠癌并接受腹腔镜手术治疗的96例患者为研究对象。回顾性分析2013年10月～2014年10月收治的45例结肠癌患者的临床资料，设为对照组，术后实施常规护理。同时回顾性分析2014年10月～2015年10月收治的51例结肠癌患者的临床资料，作为观察组，术后采用体位康复训练配合常规护理。对两组患者的术后腹胀发生情况、胃肠功能恢复情况、手术情况以及术后并发症发生率等一系列指标进行评估和比较。 结果 采用不同方案进行护理后，观察组术后2 d腹胀发生率（27.45%）显著低于对照组（55.56%），差异具有统计学意义（P<0.05）；观察组排气时间、肠鸣音恢复时间和胃肠蠕动开始时间显著低于对照组，差异具有统计学意义（P<0.05）；两组患者手术时间和术中出血量差异无统计学意义（P>0.05）；观察组住院时间、下床时间显著低于对照组（P<0.05）；观察组并发症发生率显著低于对照组，差异具有统计学意义（P<0.01）。 结论 针对结肠癌患者腹腔镜采取康复训练结合体位干预进行护理干预疗效显著，能够明显缩短患者住院时间，降低术后腹胀发生率及相关并发症几率，改善患者的胃肠功能恢复情况，提高患者的生活质量，临床上值得继续推广。

[关键词] 体位康复训练；腹腔镜；结肠癌；胃肠功能；并发症

[中图分类号] R473.7 [文献标识码] B [文章编号] 1673-9701（2017）12-0161-04

[Abstract] Objective To explore the effect of rehabilitation training combined with postural nursing intervention on gastrointestinal function and complications in the patients with colorectal cancer after the surgery of laparoscopy. Methods 96 patients who were admitted and were diagnosed as colorectal cancer and underwent laparoscopic surgery in our hospital from October 2013 to October 2015 were selected as the study subjects. The clinical data of 45 patients with colorectal cancer who were admitted to our hospital from October 2013 to October 2014 were retrospectively analyzed and were assigned to the control group， and routine nursing was performed after the surgery. At the same time， the clinical data of 51 patients with colorectal cancer who were admitted to our hospital from October 2014 to October 2015 were analyzed retrospectively and were assigned to the observation group， and postural rehabilitation training combined with routine nursing was performed after the surgery. The incidence of postoperative abdominal distension， gastrointestinal function recovery， surgery situation， the incidence of postoperative complications and other indices were evaluated and compared between the two groups. Results The incidence rate of abdominal distention 2 d after the surgery in the observation group （27.45%） was significantly lower than that in the control group （55.56%） with different nursing protocols. The difference was statistically significant（P<0.05）； the time of passage of gas， the recovery time of bowel sounds and the start time of gastrointestinal peristalsis in the observation group were significantly lower than those in the control group， and the differences were statistically significant（P<0.05）； there were no statistically significant differences in the surgery time and intraoperative blood loss between the two groups（P>0.05）；the time of hospitalization and the off-bed activity time in the observation group were significantly lower than those in the control group（P<0.05）； the incidence rate of complications in the observation group was significantly lower than that in the control group， and the difference was statistically significant（P<0.01）. Conclusion Nursing intervention of rehabilitation training combined with postural nursing intervention in the patients with colorectal cancer receiving laparoscopy has a significant efficacy， which can significantly shorten the hospital stay， reduce the incidence of postoperative abdominal distension and the related complications， improve the recovery of gastrointestinal function and improve the patients' quality of life， which is worthy of further clinical promotion.

[Key words] Postural rehabilitation training； Laparoscopy； Colorectal cancer； Gastrointestinal function； Complications

随着我国经济飞速发展和生活条件的改善，结肠癌发病率逐年升高，从2002年的7%增到2015年15%，且青少年比例较高，占15%，对我国人民身体健康尤其是青少年身体健康产生严重威胁[1]。结肠癌患者传统的治疗以开腹手术为主，近年来，医疗条件日益改善，人们对疾病治疗疗效及要求逐渐升高，由于腹腔镜手术具有创伤小、术中出血量小、术后并发症较少且患者恢复较快等诸多优势，在结直肠手术中得以广泛应用，成为结肠癌患者治疗的标准术式[2-3]。但在临床实践中发现，由于腹腔……