摘要
腹腔镜技术在结/直肠癌的治疗中已得到了广泛推广，相对于开腹手术具备一定优势。随着微创外科技术的发展、加速康复外科理念的推广，近年来肿瘤外科治疗围术期护理模式也得到发展。本文将对腹腔镜结/直肠癌根治术围术期护理进行综述，从术前护理与术后护理两个方面进行阐述。术前护理包括健康教育、心理护理、营养支持、口腔护理、肠道准备，术中护理包括感染预防、低体温预防、无瘤技术、操作配合，术后护理包括术后监测、管道管理、疼痛护理、营养指导、早期康复、造口护理。
关键词： 腹腔镜；结/直肠癌根治术；护理
Abstract
Laparoscopy has been rapidly promoted in the surgical treatment of colorectal cancer in recent years, which has certain superiority over open surgery. With the development of minimally invasive surgical techniques and the promotion of enhanced recovery after surgery, the perioperative nursing model of oncology surgery has also been developed and updated in recent years. This article will do a review on the perioperative nursing of laparoscopic radical resection of colorectal cancer, from the two aspects: preoperative nursing and postoperative nursing. Preoperative care includes health education, psychological care, nutritional support, oral hygiene, bowel preparation, intraoperative care includes infection prevention, hypothermia prevention, tumor-free techniques, operation cooperation, and postoperative care includes postoperative monitoring, pipeline management, pain management, nutritional guidance, early rehabilitation, and stoma management.
Key words： Laparoscopy; Radical resection of colorectal cancer; Nursing
参考文献 References
[1] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates ofincidence and mortality worldwide for 36 cancers in 185 countries[J]. CA: a cancer journal for clinicians, 2021, 71(3): 209-249.
[2] 孙叶飞, 张敬浩, 周禹晗. 快速康复护理在腹腔镜结直肠癌根治术患者围术期的应用[J]. 中国医科大学学报, 2019, 48(9): 848-851.
[3] 王少华, 路遥, 李曼林, 等. 基于循证的围术期护理在腹腔镜下结直肠癌根治术中的应用[J]. 中华全科医学, 2020, 18(2): 325-328.
[4] 张英, 郭敬, 杨凤霞, 等. ERAS理念下护理健康教育路径在腹腔镜肝叶切除围手术期的应用[J]. 昆明医科大学学报, 2021, 42(4): 168-171.
[5] 王淼, 杨静, 庞红叶, 等. 视频教育对腹腔镜直肠癌根治术患者不良情绪及生命体征的影响[J]. 护理实践与研究, 2021, 18(22): 3397-3399.
[6] 姜小黎, 胡艳艳. 基于叙事疗法的心理护理在早期胃癌根治术患者中的应用分析[J]. 世界华人消化杂志, 2021, 29(23): 1382-1388.
[7] 林素红, 郎杉, 岳爱华. 团体心理干预联合叙事护理在结直肠癌患者心理调适中的应用价值[J]. 中华现代护理杂志, 2020, 26(27): 3808-3812.
[8] Klassen P, Baracos V, Gramlich L, et al. Computed-tomography body composition analysis complements pre-operative nutrition screening in colorectal cancer patients on an enhanced recovery after surgery pathway[J]. Nutrients, 2020, 12(12): 3745.
[9] 刘敬钗, 孟燕沙, 陈玲玲. 术前不同营养状态对结直肠癌患者根治术后感染风险的影响[J]. 国际护理学杂志, 2021, 40(17): 3166-3170.