1、195临床研究 2023 年 03 月第 31 卷第 03 期作者简介：曹英楠，女，主管护师，本科。研究方向：胃肠外科护理方面。临床护理综合营养干预方案联合同理心护理对腹腔镜结直肠癌根治术患者营养状况及心理韧性的影响研究曹英楠，丁清清，石佩玉(郑州大学第一附属医院 胃肠外科二病区，河南 郑州 450000)摘要：目的 探讨综合营养干预方案联合同理心护理腹腔镜结直肠癌根治术患者营养状况及心理韧性的影响。方法 选择2021年5月至2022年5月于郑州大学第一附属医院行腹腔镜结直肠癌根治术共72例患者作为此次研究对象，采用随机数字表法分组，其中 36 例入对照组，实行常规护理及营养支持；另 36 例
2、入研究组，在对照组基础上实施综合营养干预方案联合同理心护理。比较两组患者干预前后的营养状况 血清总蛋白(TP)、血清白蛋白(ALB)、血清前白蛋白(PA)、体质量指数(BMI)、心理韧性 心理韧性量表(CD-RISC)及生活质量。结果 两组患者术后 1 d 营养指标相比，差异无统计学意义(P 0.05)，术后 7 d 两组指标均有下降趋势，但研究组患者 TP、ALB、PA、BMI 均高于对照组，SGA 评分高于对照组，差异有统计学意义(P 0.05)。两组干预前 CD-RISC 评分对比，差异无统计学意义(P 0.05)，两组干预后 CD-RISC 评分各维度对比差异显著，其中研究组各维度得分
3、均高于对照组，差异有统计学意义(P 0.05)。两组干预前生活质量评分对比，差异无统计学意义(P 0.05)，干预后研究组生活质量评分优于对照组，差异有统计学意义(P 0.05)。结论 对腹腔镜结直肠癌根治术实施综合营养干预方案联合同理心护理，不仅能够改善患者的营养状况，同时提高其心理韧性，以积极乐观的心态面对疾病，接受治疗，有利于病情的早日康复，进而提高生活质量。关键词：综合营养干预方案；同理心护理；腹腔镜结直肠癌根治术；营养状况；心理韧性中图分类号：R473文献标志码：B DOI：10.12385/j.issn.2096-1278(2023)03-0195-04Effect of Comp
4、rehensive Nutrition Intervention Program Combined with Empathy Nursing on Nutritional Status and Mental Toughness of Patients Undergoing Laparoscopic Radical Resection of Colorectal CancerCAO Yingnan,DING Qingqing,SHI Peiyu(The Second Ward of Gastroenterology Surgery Department,The First Affiliated
5、Hospital of Zhengzhou University,Zhengzhou Henan 450000,China)Abstract:Objective To investigate the effects of a comprehensive nutrition intervention program combined with empathy nursing on the nutritional status and mental toughness of patients undergoing laparoscopic radical resection of colorect
6、al cancer.Methods A total of 72 patients who underwent laparoscopic radical resection of colorectal cancer in the First Affiliated Hospital of Zhengzhou University from May 2021 to May 2022 were selected as subjects of this study.They were grouped by the random number table method.36 patients were e
7、nrolled in the control group and received routine nursing and nutritional support.Another 36 patients were enrolled in the study group,and combined empathy nursing was implemented on the basis of the control group.Nutritional status(serum total protein(TP),serum albumin(ALB),serum albumin(PA),body m
8、ass index(BMI),mental toughness(Mental Toughness Scale(CD-RISC)and quality of life of the two groups were compared before and after the intervention.Results 1 day after surgery,there was no statistical significance in nutritional indexes between the two groups (P 0.05),and 7 days after surgery,index
9、es of the two groups showed a decreasing trend,but the TP,ALB,PA,and BMI of the study group were higher than that of the control group,SGA score was higher than that of the control group,the difference was statistically significant(P 0.05).Before the intervention,there was no statistically significa
10、nt difference in CD-RISC score between the two groups(P 0.05).After the intervention,there were significant differences in all dimensions of CD-RISC score between the two groups,among which the scores in all dimensions of the study group were higher than those of the control group,the difference was
11、 statistically significant(P 0.05).Before the intervention,there was no statistically significant difference in the quality of life score between the two groups(P 0.05),but after the intervention,the study group was better than the control group,and the difference was statistically significant(P 0.0
12、5).Conclusion The implementation of a comprehensive nutrition intervention program combined with empathy nursing for laparoscopic radical resection of colorectal cancer can not only improve the nutritional status of patients,but also improve their mental toughness,to face the disease with an optimis
13、tic attitude,receive treatment,is conducive to the early recovery of the disease,and improve the quality of life.Key Words:comprehensive nutrition intervention program;empathetic care;laparoscopic radical resection of colorectal cancer;nutritional status;mental toughness结直肠癌是目前发病率较高的消化系统恶性肿瘤。有资料显示1，
14、该病患病人数正逐年增多，同时男女发病比是 1.651，已对人们的生命健康产生严重威胁。目前手术仍是治疗肿瘤的最佳方式，相比传统的开腹操作，196Clinical Research,Mar.2023,Vol.31 No.03腹腔镜以其创伤小、恢复快等优势，受到临床广泛应用。但手术毕竟属于侵入性操作，会对胃肠道产生一定刺激，加速机体的分解代谢，导致患者出现不同程度的营养不良，因此对患者身体机能、手术耐受情况有着更高的要求2。综合营养干预是根据患者的具体情况提供全方位的营养支持，建立合理的营养支持治疗目标。此外，患者受病情和手术应激源的影响，极易产生紧张、恐惧、焦虑等负面情绪，造成患者的神经和内分泌
15、系统紊乱或功能失常，从而影响患者的手术治疗效果，故而加强围手术期的护理干预必不可少3。同理心护理干预是近年来临床推出的一种新型护理模式，核心在于与患者“将心比心”，进而做到相互理解、关怀和情感上的融洽4。本研究选择郑州大学第一附属医院行腹腔镜结直肠癌根治术共 72 例患者作为此次研究对象，评价综合营养干预方案联合同理心护理的应用效果，现报道如下。1资料与方法1.1两组患者一般资料比较选择本院 2021 年 5 月至 2022 年 5 月行腹腔镜结直肠癌根治术共 72 例患者作为此次研究对象。将符合纳入标准的患者分为两组各 36 例，分组方式为随机数字表法，两组基线数据具有可比性，差异无统计学意
16、义(P0.05)。见表 1。本研究通过本院院内伦理委员会批准。纳入标准：均结合辅助检查、术后病理结果明确诊断为直肠癌或者结肠癌5；术前评估符合腹腔镜手术有关治疗指征，同时无治疗禁忌症；具备正常的认知能力，可配合完成此次研究。排除标准：肝肾心等重要脏器有严重功能不全者；存在控制不良糖尿病或者高血压等并发症者；存在造血功能或者血液疾病者；治疗部位存在感染、破溃者；伴严重精神病者；拒绝或者中途退出此次研究者。表1两组患者一般资料比较sx，n(%)项目对照组(N=36)研究组(N=36)2/t/UP年龄/岁52.562.4452.592.510.0500.960BMI/(kg/m2)23.120.6623.480.420.3680.714性别0.0600.806男20(55.56)19(52.78)女16(44.44)17(47.22)文化程度0.0260.979初中及以下8(22.22)7(19.44)高中及中专16(44.44)18(50.00)大专及以上12(33.33)11(30.56)Dukes 分期0.5750.565A 期1(2.78)2(5.56)B 期8(22.22)10(2