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目的探讨早期综合护理联合生脉注射液对胃肠道恶性肿瘤患者手术后并发症和临床体征的影响。方法选取2011年5月至2015年4月于广安市人民医院接受手术治疗的84例胃肠道恶性肿瘤患者,按入院顺序编号分为对照组和观察组,每组42例。对照组患者给予常规护理,观察组患者给予早期综合护理联合生脉注射液方案,比较两组患者干预前后免疫球蛋白Ig A、Ig M、Ig G和T细胞亚群CD3~+、CD4~+、CD8~+指标的变化,记录两组患者腹痛腹胀缓解时间、肛门首次排气时间、排便时间和进食时间,统计两组患者手术后并发症发生率。结果 (1)两组患者术前CD3~+、CD4~+和CD8~+比较,差异无统计学意义(P>0.05)。手术后2周,观察组患者CD3~+、CD4~+上升,明显高于对照组;CD8~+无明显变化,对照组有所降低,两组患者CD8~+比较,差异有统计学意义(P<0.05)。(2)两组患者手术前、手术后2周Ig A无明显变化;手术后2周,观察组Ig G、Ig M上升,对照组Ig G、Ig M均下降,两组患者Ig G、Ig M比较差异有统计学意义(P<0.05);(3)观察组腹痛腹胀缓解时间、首次肛门排气时间、排便时间和进食时间均短于对照组,差异有统计学意义(P<0.05)。(4)观察组手术后各并发症发生率均低于对照组,仅胃肠道反应发生率比较差异有统计学意义(P<0.05)。结论胃肠道恶性肿瘤患者采用早期综合护理联合生脉注射液干预,可提升免疫功能,缩短手术后胃肠道功能恢复时间,降低并发症发生率。
Objective To investigate the effect of early comprehensive nursing combined with Shengmai injection on postoperative complications and clinical signs in patients with gastrointestinal cancer. Methods From May 2011 to April 2015, 84 patients with gastrointestinal cancer undergoing surgery in Guang’an People’s Hospital were enrolled and divided into control group and observation group according to the order of hospitalization, with 42 cases in each group. The patients in the control group were given routine care. The patients in the observation group were treated with Shengmai Injection in the early comprehensive care. Before and after treatment, the immunoglobulin Ig A, Ig M, Ig G and T cell subsets CD3 +, CD4 + , CD8 ~ + index changes, the two groups were recorded abdominal pain and abdominal distension time, anal first exhaust time, defecation time and eating time, statistics of the incidence of postoperative complications in both groups. Results (1) There was no significant difference in the preoperative CD3 ~ +, CD4 ~ + and CD8 ~ + between the two groups (P> 0.05). The levels of CD3 ~ + and CD4 ~ + increased in the observation group at 2 weeks after operation, which were significantly higher than those in the control group. There was no significant change in the level of CD8 ~ + in the control group, and the difference was statistically significant P <0.05). (2) There was no significant change of Ig A in the two groups before surgery and 2 weeks after operation. Ig G and Ig M in the observation group increased after 2 weeks of operation, and both Ig G and Ig M decreased in the control group (P <0.05). (3) The time of relieving abdominal distension, the time of first anal exhaust, the time of defecation and eating time in the observation group were all shorter than those in the control group (P <0.05) . (4) The morbidity of each complication in the observation group was lower than that in the control group, and the incidence of gastrointestinal tract only had statistical significance (P <0.05). Conclusion Early comprehensive gastrointestinal cancer patients treated with Shengmai injection can improve immune function, shorten the recovery time of postoperative gastrointestinal function and reduce the incidence of complications.