赋能理论结合快速康复外科理念在肾癌根治术患者围手术期护理中的应用

王燕; 葛余正; 程静

doi:10.16766/j.cnki.issn.1674-4152.003982

赋能理论结合快速康复外科理念在肾癌根治术患者围手术期护理中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003982

王燕¹,
葛余正²,
程静^1, ,

1.
南京医科大学附属南京医院(南京市第一医院)麻醉疼痛与围手术期医学科，江苏南京 210000
2.
南京医科大学附属南京医院(南京市第一医院)泌尿外科

基金项目:

国家自然科学基金青年科学基金项目 81802531

详细信息

通讯作者:
程静，E-mail：m13770342656@163.com

中图分类号: R737.11 R493
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- 文章访问数: 3
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- 被引次数: 0
出版历程
- 收稿日期: 2024-05-05
- 网络出版日期: 2025-06-30

The application of enabling theory combined with rapid rehabilitation surgery in perioperative nursing for patients undergoing radical nephrectomy

1.
Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, China

摘要

摘要: 目的探究赋能理论结合快速康复外科理念在肾癌根治术患者围手术期护理中的应用效果，以期为临床肾癌根治术护理方案的选择提供理论指导。方法选取南京医科大学附属南京医院2021年1月—2023年12月诊治的拟行肾癌根治术患者102例，按随机数字表法分为2组。对照组(51例)接受围手术期常规护理，研究组(51例)在此基础上接受赋能理论结合快速康复外科理念护理。比较2组术后恢复指标、心理状况、应对方式及并发症。结果研究组住院时间、首次进食时间、肛门排气时间、下床活动时间均短于对照组(P＜0.05)。干预后，研究组SDS、SAS评分分别为(48.16±2.97)分、(46.64±3.25)分，均低于对照组的(53.01±1.05)分、(50.12±1.01)分(P＜0.05)。干预后，研究组屈服评分[(7.38±0.96)分]、回避评分[(9.25±2.01)分]均低于对照组[(9.47±1.35)分、(12.73±2.88)分]，面对评分[(21.52±4.09)分]高于对照组[(17.41±3.28)分，均P＜0.05]。研究组术后并发症总发生率为5.88%(3/51)，低于对照组[19.61%(10/51)，χ²=4.320, P=0.038]。结论赋能理论结合快速康复外科理念应用于肾癌根治术患者围手术期护理效果确切，可明显改善患者心理状况，有助于术后快速恢复。
- 肾癌 /
- 赋能理论 /
- 快速康复外科理念 /
- 围手术期
Abstract: Objective This study aims to investigate the application of the enabling theory combined with the concept of rapid rehabilitation surgery in perioperative nursing for patients undergoing radical nephrectomy, providing theoretical guidance for the selection of optimal clinical nursing programs. Methods A total of 102 patients who were expected to undergo radical nephrectomy in Nanjing First Hospital, Nanjing Medical University from January 2021 to December 2023 were chosen and separated into the control group (n=51, perioperative routine nursing) and the study group (n=51, enabling theory combined with the concept of rapid rehabilitation surgery) according to random number table method. Postoperative recovery indexes, psychological status, coping strategies, and complications of the two groups were compared. Results The hospitalization time, first feeding time, anal exhaust time, and time to ambulation in the study group were shorter than those in the control group (P < 0.05). SDS and SAS scores after the intervention in the study group were lower than the study group [(48.16±2.97) points and (46.64±3.25) points vs. (53.01±1.05) points and (50.12±1.01) points, P < 0.05]. In contrast to the control group, the yield and avoidance scores after the intervention in the study group were lower [(7.38±0.96) points and (9.25±2.01) points vs. (9.47±1.35) points and (12.73±2.88) points], while the face scores were higher [(21.52±4.09) points vs. (17.41±3.28) points, P < 0.05]. The study group had lower total incidence of postoperative complications compared with the control group [5.88% (3/51) vs. 19.61% (10/51), χ²=4.320, P=0.038]. Conclusion Enabling theory combined with the concept of rapid rehabilitation surgery in the perioperative nursing of patients undergoing radical nephrectomy is effective, significantly improve psychological well-being, and promotes faster recovery after surgery.
- Radical nephrectomy /
- Enabling theory /
- The concept of rapid rehabilitation surgery /
- Perioperative period

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表 1 2组肾癌根治术患者术后恢复指标比较(x±s)

Table 1. Comparison of postoperative recovery indexes before and after intervention between two groups of patients undergoing radical nephrectomy (x±s)

组别	例数	住院时间(d)	首次进食时间(h)	肛门排气时间(h)	下床活动时间(h)
研究组	51	4.72±0.96	7.85±2.04	14.49±3.15	8.71±2.37
对照组	51	5.41±1.52	18.26±3.69	20.17±4.46	25.39±5.91
t值		2.741	17.632	7.429	18.707
P值		0.007	＜0.001	＜0.001	＜0.001

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表 2 2组肾癌根治术患者干预前后心理状况比较(x±s，分)

Table 2. Comparison of psychological status before and after intervention between two groups of patients undergoing radical nephrectomy (x±s, points)

组别	例数	SDS		t值	P值	SAS		t值	P值
组别	例数	干预前	干预后	t值	P值	干预前	干预后	t值	P值
研究组	51	57.16±3.63	48.16±2.97	19.477	＜0.001	54.97±4.46	46.64±3.25	15.431	＜0.001
对照组	51	57.21±3.49	53.01±1.05	13.213	＜0.001	54.88±4.13	50.12±1.01	13.227	＜0.001
统计量		0.070^a	34.915^b			0.105^a	23.188^b
P值		0.945	＜0.001			0.917	＜0.001
注：^a为t值，^b为F值。

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表 3 2组肾癌根治术患者干预前后应对方式比较(x±s，分)

Table 3. Comparison of coping styles before and after intervention between two groups of patients undergoing radical nephrectomy (x±s, points)

组别	例数	屈服		t值	P值	回避		t值	P值	面对		t值	P值
组别	例数	干预前	干预后	t值	P值	干预前	干预后	t值	P值	干预前	干预后	t值	P值
研究组	51	13.24±1.45	7.38±0.96	34.729	＜0.001	15.79±3.41	9.25±2.01	17.234	＜0.001	10.74±2.15	21.52±4.09	24.675	＜0.001
对照组	51	13.08±1.62	9.47±1.35	17.361	＜0.001	15.28±3.62	12.73±2.88	5.603	＜0.001	10.89±2.33	17.41±3.28	16.600	＜0.001
统计量		0.520^a	28.612^b			0.724^a	22.470^b			0.334^a	17.777^b
P值		0.601	＜0.001			0.467	＜0.001			0.737	＜0.001
注：^a为t值，^b为F值。

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表 4 2组肾癌根治术患者并发症发生情况比较[例(%)]

Table 4. Comparison of complications between two groups of patients undergoing radical nephrectomy[cases (%)]

组别	例数	胃肠道不适	尿路感染	下肢深静脉血栓	总发生
研究组	51	3(5.88)	0	0	3(5.88)
对照组	51	6(11.76)	3(5.88)	1(1.96)	10(19.61)
注：2组并发症总发生率比较，χ²=4.320，P=0.038。

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