摘要
目的探究基于计划-实施-检查-处理(PDCA)管理的多模式疼痛干预对肝癌患者术后康复的影响。方法将144例肝癌手术患者按干预方法的不同分为对照组(72例)和联合组(72例)。对照组患者给予常规镇痛干预,联合组患者给予基于PDCA管理的多模式疼痛干预。比较两组患者焦虑、抑郁情绪及术后疼痛;统计两组患者术后胃肠功能指标、肝功能指标[总胆红素(TBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]及生活质量。结果术后,两组患者汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均明显低于本组术前,且联合组患者HAMA、HAMD评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。联合组患者肛门首次排气时间、肠鸣音恢复时间、肛门首次排便时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。术后6、24、48、72 h,联合组患者数字评定量表(NRS)评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。术后,两组患者TBIL、ALT及AST水平均明显高于本组术前,且联合组患者ALT、AST水平均明显低于对照组,差异均有统计学意义(P﹤0.01)。术后,两组患者躯体功能、生理功能、心理功能及社会功能评分均明显高于本组术前,且联合组患者躯体功能、生理功能、心理功能及社会功能评分均明显高于对照组,差异均有统计学意义(P﹤0.01)。结论基于PDCA管理的多模式疼痛干预可以加快肝癌患者术后康复进程,减轻疼痛感,缓解患者负性情绪,且术后患者肝功能良好,生活质量提高,可在临床推广应用。
Objective To explore the effect of multimodal pain intervention based on plan-do-check-action(PDCA)on postoperative rehabilitation of patients with liver cancer.Method A total of 144 patients undergoing liver cancer surgery were divided into the control group(72 cases)and joint group(72 cases)according to different intervention methods.The control group was given conventional analgesia intervention,and the joint group was given multimodal pain intervention based on PDCA.The anxiety,depression and postoperative pain of the two groups were compared;the gastrointestinal function,liver function indexes[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)]and quality of life were evaluated.Result The scores of the Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)of the two groups after operation were lower than those before operation,with lower scores in the joint group than those in the control group(P<0.01).The first exhaust time,recovery time of bowel sounds and the first defecation time in the joint group were shorter than those in the control group(P<0.01);the scores of number rating scale(NRS)at 6,24,48 and 72 hours after operation in the joint group were lower than those in the control group(P<0.01);the levels of TBIL,ALT and AST in the two groups after operation were higher than those before operation,with lower levels of ALT and AST in the joint group than those in the control group(P<0.01);the scores of physical function,physiological function,psychological function and social function in the two groups after operation were all higher than those before operation,with higher scores in the joint group than those in the control group(P<0.01).Conclusion Multimodal pain intervention based on PDCA can speed up the postoperative recovery of liver cancer patients,reduce pain and relieve patients’negative emotions,and the postoperative liver function of patients is good,which can significantly improve the quality of life of patients,and can be applied in clinical practice.
作者
马明辉
王红军
刘剑芳
MAMinghui;WANG Hongjun;LIU Jianfang(Department of Hepatobiliary and Pancreatic,Affiliated Cancer Hospital of Zhengzhou University(He’nan Cancer Hospital),Zhengzhou 450003,He’nan,China)
出处
《癌症进展》
2022年第17期1767-1770,1774,共5页
Oncology Progress
关键词
PDCA管理
疼痛
肝癌
术后康复
PDCA management
pain
liver cancer
postoperative rehabilitation
