医护一体化联合加速康复外科理念对肝癌肝切除患者低蛋白血症的影响

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Abstract Objective To study the effect of medical and nursing integration combined with enhanced recovery after surgery (ERAS) on hypoproteinemia in hepatectomy patients. Methods From August 2014 to January 2017, in Hu'nan Provincial People′s Hospital, 78 patients with hypoproteinemia after hepatectomy were selected, according to the random number method, they were divided into the control group and observation group, with 39 cases in each group. The control group was given doctor and nurse integration, the observation group was given doctor and nurse integration combined with enhanced recovery. The improvement of fatigue feeling, complications, negative emotion score, nutrition index and insulin-like growth factor-1 (IGF-1) and alanine aminotransferase (ALT) level in the two groups after intervention were analyzed. Results After intervention, the fatigue feeling rate, body weight and grip strength in two groups improved compared with before intervention, and the fatigue feeling rate in observation group was lower than control group, body weight and grip strength in observation group were stronger than control group, the differences were statistically significant (P < 0.05). The time of intestinal exhaust time, defecate, restore complete oral diet in observation group was less than control group, the differences were statistically significant (P < 0.05). After intervention, the level of prealbumin, transferrin, albumin in two groups increased, and the level of prealbumin, transferrin, albumin in observation group were higher than control group, the differences were statistically significant (P < 0.05). After intervention, the levels of IGF-1 in two groups were higher than before intervention, the levels of ALT were lower than before intervention, and the levels of IGF-1 and ALT in observation group were better than control group, the differences were statistically significant (P < 0.05). After intervention, self-rating anxiety scale (SAS), self-rating depression scale (SDS) scores in two groups were reduced comprared with before intervention, and those in observation group were lower than control group, the differences were statistically significant (P < 0.05). The satisfaction score in observation group was higher than control group, the difference was statistically significant (P < 0.05), but there was no statistical difference in the incidence of complications between two groups (P > 0.05). Conclusion Patients with hypoproteinemia after liver cancer treated with the combination of medical care and ERAS concept can reduce the fatigue, improve the body nutrition level, lower the serum IGF-1 level, reduce the negative emotions of patients, and improve the patient satisfaction.

Key words： Integration of doctor and nurse Enhanced recovery after surgery Liver cancer Hypoproteinemia

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	YU Qiu XU Xiaoping ZHAO Min LIU Yingyan PENG Xiangqun▲

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YU Qiu XU Xiaoping ZHAO Min LIU Yingyan PENG Xiangqun▲. Effect of doctor and nurse integration combined with enhanced recovery after surgery on hypoproteinemia in patients with liver cancer after hepatectomy[J]. 中国医药导报, 2018, 15(25): 164-168.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I25/164

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