金雪妹 冯文明

[摘要] 目的 探讨集束化治疗护理措施对胰腺癌术后复发的影响。 方法 选取2014年2月至2017年1月在本院行手术治疗的92例胰腺癌患者，其中观察组47例患者接受集束化治疗护理措施，其余对照组45例患者接受普通护理措施。比较两组患者无复发生存情况及首次转移部位。 结果 在术后3年内，对照组34例复发，无复发生存率为24.44%（11/45）;观察组31例复发，无复发生存率为34.04%（16/47），两组3年无复发生存率比较，差异无统计学意义（P=0.139;风险比：0.699;95%CI：0.428～1.142）。两组患者中，最常见的首次复发部位为局部复发，共有31例患者发生局部复发（对照组16例，观察组15例）。两组患者在复发部位方面比较，差异无统计学意义（P>0.05）。 结论 集束化治疗护理措施应用于胰腺癌患者围术期，不会对其术后复发生存产生不利影响。

[关键词] 胰腺癌;集束化护理;胰腺切除;生存;复发

[中图分类号] R473.5          [文献标识码] B          [文章编号] 1673-9701（2021）03-0172-04

Impacts of bundle therapy and nursing measures on postoperative relapse of pancreatic cancer

JIN Xuemei   FENG Wenming

Department of Surgery， the First People′s Hospital Affiliated to Huzhou University， Huzhou   313000， China

[Abstract] Objective To investigate the impacts of bundle therapy and nursing measures on postoperative relapse of pancreatic cancer. Methods From February 2014 to January 2017， a total of 92 patients with pancreatic cancer underwent surgical treatment were selected in our hospital. The observation group（n=47） was received bundle therapy and nursing measures， and the control group（n=45） was received routine nursing measures. The relapse-free survival and the first metastatic site of the two groups were compared. Results Within 3 years postoperation， 34 cases in the control group relapsed， and the relapse-free survival rate was 24.44%（11/45）. There were 31 cases of relapse in the observation group， and the relapse-free survival rate was 34.04%（16/47）， there was no significant difference in the 3-year relapse-free survival rate between the two groups（P=0.139; Risk ratio： 0.699; 95%CI： 0.428-1.142）. In the two groups of patients， the most common first relapse site was a topical relapse， with a total of 31 patients having a topical relapse（16 cases in the control group， 15 cases in the observation group）. There was no significant difference in relapse site between the two groups（P>0.05）. Conclusion Bundle therapy and nursing measures applied to pancreatic cancer patients during the perioperative period do not adversely affect their postoperative relapse and survival.

[Key words] Pancreatic cancer; Bundle nursing; Pancreas resection; Survival; Relapse

胰腺癌在全世界范圍内仍然是重大的公共卫生难题，发病率呈快速上升趋势[1]，据统计胰腺癌位居中国城市男性恶性肿瘤发病率的第8位，居北京市和上海市人群恶性肿瘤死亡率的第5位[2-3]。尽管在胰腺癌预防、诊断和治疗方面取得了长足的进步，但胰腺癌术后复发率高，5年生存率仍十分不理想[4]。目前对于胰腺癌，根治性手术仍是最有效的治疗手段[5]，但胰腺癌手术创伤大、手术时间长，手术使机体产生剧烈的应激反应，造成全身各脏器均受到不同程度的受累，从而导致患者术后恢复缓慢，并发症发生率高，甚至影响患者接受术后进一步治疗[6-7]。集束……