| 【Objective】1.To investigate the effects of the oral spray with 4°C coconut water or 4°C drinking water or no oral spray on the postoperative patients with colorectal tumor.2.Try to develop the medical value of natural coconut water and provide experiences and theoretical supports for the development of the tropical nursing characteristics.【Method】A prospective randomized control method was used to select 90 patients with colorectal tumors requiring surgery in oncology surgery and general surgery in the second affiliated hospital of Hainan Medical College from February 2019 to September 2019.The control group was randomly divided into control group,intervention group 1 and intervention group 2,in which the control group was treated with traditional ERAS diet time without postoperative oral spray,intervention group 1was given 4°C drinking water oral spray on the basis of control group,and intervention group 2 was given 4°C coconut water oral spray on the basis of control group.The three groups were dynamically evaluated for oral humidity,dry mouth expression,lip mucosal moistness,exhaust time,abdominal distention and comfort to evaluate their intervention effect on postoperative oral dryness and gastrointestinal dysfunction.【Result】1.Baseline comparison: There was no significant difference in demographic data,disease related data and preoperative and postoperative basic evaluation index among the three groups of patients(P >0.05).2.Comparison of oral humidity in the three groups:The comparison within 6hours of intervention showed that the oral humidity of intervention 2 group was significantly higher than that of intervention 1 group and control group,and the difference was statistically significant(P<0.01).At the same time,the oral humidity of intervention 1 group was not statistically significant compared with control group(P>0.05).between morning and bedtime on the second day of intervention,the oral humidity of intervention group 2 was higher than that of intervention group 1 and control group,and the difference was statistically significant(P<0.05).During the morning of the third day of intervention,there was no significant difference in oral humidity in the three groups(P>0.05).between bedtime on the 3rd day of intervention and bedtime on the 4th day of intervention,there was no significant difference in oral humidity between intervention group 1 and control group(P>0.05).3.Comparison of dry mouth expression in the three groups: Comparison within 6hours showed that the expression of dry mouth in intervention group 2 was significantly smaller than that in intervention group 1 and control group(P<0.01),and the expression of dry mouth in intervention group 1 was smaller than that in control group(P<0.05).On the second day of intervention,the expression of dry mouth in intervention group 2 was lower than that in intervention group 1,and the difference of oral humidity in intervention group 1 was statistically significant(P<0.05).on the morning of the 3rd day of intervention,the dry-mouth expression of intervention group 1 was not statistically significant compared with that of intervention group 2and control group(P>0.05),but the dry-mouth expression of intervention group 2 was significantly lower than that of control group(P<0.05).The expression of dry mouth in the control group before going to bed on the 3rd day was higher than that in the intervention group 1,the difference was statistically significant(P<0.05).On the 4th day of intervention,the expression of dry mouth in intervention group 1 and control group was not statistically significant(P>0.05).4.Comparison of mucosal moistness in three groups: Comparison within 6 hours of intervention showed that the moisturizing degree of oral mucosa of lip and tongue in intervention group 2 was significantly higher than that in intervention group 1 and control group(P<0.01),and the moisturizing degree of oral mucosa of lip and tongue in intervention group 1 was higher than that in control group(P<0.01).On the second day of intervention,the wetting degree of lip mucosa in intervention group 2 was significantly higher than that in intervention group 1 and control group(P<0.01),and compared with the control group,the oral mucosal moistness in the same intervention group was statistically significant(P<0.01).In the morning of the 3rd day of intervention,the wetting degree of lip mucosa was higher than that of the control group(P<0.05),there was no significant difference(P>0.05)between intervention group 1 and intervention group 2 and control group.Meanwhile,before going to bed on the 3rd day of intervention to the 4th day of bedtime,the degree of moistness of lip mucosa between intervention group 1 and control group was not statistically significant(P>0.05).5.The postoperative anal exhaust time of the three groups was compared: the postoperative anal exhaust time of the intervention group 2 was significantly shorter than that of the intervention group 1 and the control group,and the difference was statistically significant(P<0.001).at the same time,there was no significant difference between the intervention group 1 and the control group(P>0.05).6.Comparison of postoperative abdominal distention in three groups:Comparison within 6 hours of intervention showed that the degree of abdominal distension in intervention group 2 was significantly lower than that in intervention group 1 and control group(P<0.05),and the degree of abdominal distension in intervention group1 was lower than that in control group(P<0.01).On the second day of intervention,the degree of abdominal distention in the control group was higher than that in the intervention group 1 and 2 groups(P<0.05).At the same time,there was no significant difference in the degree of abdominal distention between intervention group 1 and intervention group 2(P>0.05).in the morning of the third day of intervention,there was no significant difference in the degree of abdominal distention between intervention group 1 and intervention group 2 and control group(P>0.05).however,the degree of abdominal distention in intervention group 1 was significantly lower than that in control group(P<0.05).Meanwhile,between the 3rd day of intervention and the 4th day before bedtime,the abdominal distention degree of intervention group 1 and control group was not statistically significant(P>0.05).7.Comparison of postoperative comfort in three groups: Comparison within 6hours of intervention showed that the comfort of intervention 2 group was significantly smaller than that of intervention 1 group and control group,the difference was statistically significant(P<0.01),and the comfort of intervention 1group was smaller than that of control group(P<0.05).In the morning and before bedtime on day 2 of intervention,the comfort score of intervention group 2 was significantly lower than that of intervention group 1 and control group,and the difference was statistically significant(P<0.01).at the same time,the comfort of intervention group 1 was compared with control group,and the difference was not statistically significant(P>0.05).On the morning of day 3 of intervention,the comfort score of intervention group 2 was lower than that of intervention group 1 and control group,the difference was statistically significant(P<0.05).at the same time,the comfort of intervention group 1 was compared with control group,and the difference was not statistically significant(P>0.05).there was no significant difference in comfort between the intervention group 1 and the control group before going to bed on day 3 to day 4 of intervention(P >0.05).【Conclusion】1.The patients with colorectal tumor had dry mouth and gastrointestinal dysfunction after operation.2.4°C coconut water spray can significantly improve the postoperative oral humidity,relieve dry mouth sensation,wet lip mucosa,shorten the postoperative anal exhaust time,relieve the degree of abdominal distention,improve the postoperative comfort and its effect is better than that of 4°C drinking water spray without spray.3.The present study confirms the physiological connection between oral cavity and gastrointestinal tract,while affirming the medical value of coconut water,and provides empirical support for the further development of the tropical care methods of ERAS with Chinese characteristics. |
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