陈秀云 方玉柳 谢玲女

[摘要] 目的 探討多学科团队合作模式在卵巢癌术后回肠造口管理中的应用与效果评价。 方法 选择2018年7—12月在我院行卵巢癌减瘤术加回肠造瘘术患者80例为研究对象，按时间节点分为对照组45例和观察组35例，对照组采取常规护理，观察组在常规护理基础上采取多学科合作方式，比较两组患者并发症发生率、并发症愈合时间、患者满意度等。 结果 观察组并发症发生率为11.43%显著性低于对照组的26.67%，差异具有统计学意义（χ2=4.351，P<0.05），观察组满意度为100.00%显著性高于对照组（82.22%），差异具有统计学意义（χ2=6.892，P<0.05）。 结论 多学科团队合作的卵巢癌术后回肠造口管理有助于降低造口并发症发生率，提高患者满意度，推荐临床采用。

[关键词] 多学科合作;卵巢癌减瘤术;回肠造口;护理

[中图分类号] R473          [文献标识码] B          [文章编号] 1673-9701（2021）08-0180-03

Management of the relevant ileostomy after cytoreductive surgery for ovarian cancer based on multidisciplinary cooperation

CHEN Xiuyun1   FANG Yuliu2   XIE Lingnv1

1.Department of Colorectal Surgery， Zhejiang Cancer Hospital， Hangzhou   310022， China; 2.Department of Gynecological Oncology， Zhejiang Cancer Hospital， Hangzhou   310022， China

[Abstract] Objective To explore the application and effect evaluation of the model of multidisciplinary team cooperation in the management of the relevant ileostomy after cytoreductive surgery for ovarian cancer. Methods From July to December 2018， 80 patients who underwent cytoreductive surgery for ovarian cancer and ileostomy in our hospital were selected as the subjects of research and divided into the control group（n=45） and the observation group（n=35） according to time nodes. The control group received conventional nursing， while the observation group received the mode of multidisciplinary cooperation on the basis of conventional nursing. The incidence of complications， the time for recovery from complications and the patients′ satisfaction， etc. were compared between the two groups of patients. Results The results of the study showed that the incidence of complications in the observation group was 11.43%， significantly lower than the 26.67% in the control group， and the difference was statistically significant（χ2=4.351， P<0.05）. The satisfaction of the observation group was 100.00%， significantly higher than the 82.22% of the control group， and the difference was statistically significant（χ2=6.892， P<0.05）. Conclusion Multidisciplinary team cooperation management of the relevant ileostomy after cytoreductive surgery for ovarian cancer helps to reduce the incidence of stoma complications and improve the patients′ satisfaction. It is worthy of recommendation for clinical application.

[Key words] Multidisciplinary cooperation; Cytoreductive surgery for ovarian cancer; Ileostomy; Nursing

多学科团队协作（MDT）是以患者为核心，多学科团队合作的管理策略[1]。卵巢癌肿瘤细胞减灭术是对Ⅲ期及以上患者的常用手术方式，但50%的晚期卵巢癌减瘤术中常涉及肠道相关手术（如肠道切除、肠道吻合、肠道造瘘等）[2]。有研究显示[3]预防性回肠造瘘术可减少术后吻合口瘘的发生，而经回肠造口排出的粪便消化酶类含量丰富、临时性造口常常位置不合理、形状不规则、有支撑杆等均增加了护理难度，使自我护理困难。本研究通过MDT的管理模式对卵巢癌术后回肠造口进行护理，取得了较好效果，现报道如下。

1 资料与方法

1.1一般资料

选择2018年7—12月在我院行卵巢癌减瘤术加回肠造瘘术患者80例为研究对象，所有患者均对本研究知情，并愿意配合，均能书写及阅读的患者，其中2018年7—9月的患者45例，为对照组，采用常规方法，选取2018年10—12月的患者35例，为观察组，采用多学科合作方式，术前护士参与MDT讨论，根据患者情况进行术前造口定位。……