Application Of Pre-rehabilitation Nursing Strategy In Perioperative Period Of Laparoscopic Radical Gastrectomy

Objective: To explore the application of pre-rehabilitation nursing strategy in perioperative period of laparoscopic radical gastrectomy for patients with gastric cancer.METHODS: A total of 94 patients with gastric cancer diagnosed by imaging or endoscopic pathology after laparoscopic radical resection in our hospital from September 2019 to September 2020 were selected,and all patients were divided into observation group（n=48）and control group（n=46）according to random number method.Patients in the control group were given routine nursing intervention,and patients in the observation group were given pre-rehabilitation nursing strategy intervention.Postoperatively,the general conditions of perioperative period in the two groups were compared,including operative time,intraoperative blood loss,first exhaust time,first activity time out of bed,first feeding time and postoperative hospitalization time.The indexes of gastrointestinal function,nutritional status and immune function were compared between the two groups before intervention,1 day before operation and7 days after operation.Hospital Anxiety and Depression Scale（HADS）was used to evaluate and compare the psychological status of patients in the two groups before intervention,1 day before surgery,and 30 days after surgery.Thirty-six items of health survey（SF-36）were used to evaluate and compare the quality of life of patients in the two groups before interventionon,the day before surgery,and 30 days after surgery.Visual analogue pain scale（VAS）was used to evaluate the pain of the two groups on the 1st,3rd and 7th day after surgery.The incidence of postoperative adverse reactions,such as pulmonary infection,anastomotic fistula,intestinal obstruction,gastroparesis,urinary tract infection,wound infection and deep vein thrombosis,were statistically compared between the two groups.RESULTS: There were no significant differences in operation time and intraoperative blood loss between the two groups（P>0.05）.Compared with the control group,the first exhaust time,the first activity time out of bed,the first feeding time and the postoperative hospitalization time in the observation group were significantly decreased（P<0.05）.Two groups of patients in the GAS before the intervention,PA,propagated and agency level had no significant difference（P > 0.05）,compared with before intervention,two groups of 1 d GAS before surgery,PA,propagated and agency levels were significantly increased,compared with the preoperative 1 d,two groups in postoperative 7 d GAS,PA,propagated and agency levels were significantly decreased（P < 0.05）,compared with control group,the observation group of patients in preoperative 1 d and 7 d after GAS,PA,propagated and agency levels were significantly higher（P < 0.05）;Compared with before intervention,the levels of Ig M,Ig G,Ig G1 and TLC in 2 groups were significantly increased 1d before surgery（P<0.05）;compared with the control group,the levels of Ig M,Ig G,Ig G1 and TLC in observation group were significantly increased 1d before surgery and 7d after surgery（P<0.05）.There were no significant differences in HADS-A and HADS-D scores between the two groups before intervention（P>0.05）.Compared with the control group,HADS-A and HADS-D scores of the observation group were significantly decreased 1 day before operation and 30 days after operation（P<0.05）.The SF-36 scores of 2 groups at 1 and 30 days before surgery were significantly higher than before intervention,and the increase range of observation group was significantly higher than control group（P<0.05）.The VAS scores of the observation group on the 1st,3rd and 7th day after surgery were significantly lower than those of the control group,and the difference was statistically significant（P<0.05）.Compared with the control group,the total incidence of postoperative pulmonary infection,anastomotic fistula,intestinal obstruction,gastroparesis,urinary tract infection,wound infection and deep vein thrombosis in the observation group was significantly lower than that in the control group（P<0.05）.Conclusion: early rehabilitation nursing strategies in gastric cancer perioperative application effect of laparoscopic radical exactly,it can significantly improve the quality of life of patients with gastrointestinal function,immune function,and improve the nutritional status of patients,reduce the pain of patients,shorten their hospitalization time and lower the incidence of postoperative complications,worthy of further clinical application.