Systematic Pain Intervention Combined Nutrition Support Accelerate Postoperative Rehabilitation Of Liver Cancer Patients

Objective:To explore Systematic pain intervention combined early nutrition support accelerate the postoperative rehabilitation of the patients with primary liver cancer. and to provide the scientific basis for the implementation of effective care in clinical.Methods:According to the concept of fast track surgery, query systematic reviews and evidence-based nursing information on the best practices report of the JBI, as well as Cochrane, OVID, Pubmed, NGC, experts to consult, and then draw up the Systematic pain intervention combined early nutrition support for patients with with primary liver cancer underwent hepatectomy. From June 2013 to June 2014, A total of 200 patients with primary liver cancer who were initially cured in the department of hepatobiliary Surgery of Tumor Hospital of the Guangxi Medical University were selected and were randomly divided into two groups,100 patients were selected as experiment group and the other 100 patients as the control group. There is no significant difference in gender, age, Barcelona Clinic Liver Cancer, intraoperative blood loss, the maximum diameter of the tumor, liver door block of time and operation time (P>0.05). Patients in control group received the routine treatment and nursing. Patients in experiment group were given Systematic pain intervention, such as patient-controlled intravenous analgesia during the period of postoperative 48h.Analgesic liquid formula include sufentanil citrate 2ml,tropisetron hydrochloride 10ml,flurbiprofen axetil 10ml and normal saline 74ml,after 48h,assess the pain score once every 4h,patients were treated with non-pharmacological interventions at the score of 3 points or less, Such as listening to soft music, getting comfortable position, massaging acupoints, given oral painkillers, such as ibuprofen, diclofenac at the score of 4 to 6, given intramuscular analgesics, such as tramadol injection at the score of 6 points or more. Patients in experiment group were given early oral feeding and early nutrition support.The following parameters were compared between the two group:the pain scores, Pain remission, sleeping hours;time to the start of recovery of bowel sounds, time to anus deaeration, time to defecation and the incidence rate of Nausea, vomiting, throat discomfort, abdominal distension; The albumin(ALB),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were compared between the two groups on postoperative day 4. It is statistically significant when P<0.05.Results:1.The pain scores of experiment group were significantly lower than the control group at 4h,12 h,24 h and 48 h after operation(P<0.05).2.The time of sleeping was significantly more than the control group at the first, second and third day after surgery(P<0.05).3.The total remission rate of pain was significantly higher than the control group at the third day after operation(P<0.05).4.Time to the start of recovery of bowel sounds, time to anus deaeration, time to Defecation in observation group were all significantly lower than the control group and the incidence rate of Nausea, vomiting, throat discomfort, abdominal distension in experiment group were all significantly higher than the control group. There was statistically significant difference (P<0.05).5. the levels of ALB、ALT and AST between the two groups had no statistical difference (both P>0.05). The level of ALB in experiment group was significantly higher than the value in control group (P<0.05), the levels of ALT and AST in experiment group were significantly lower compared with control group (P<0.05).Conclusion:The systematic effective pain intervention for patients who underwent hepatectomy reduced postoperative pain and increased sleeping time at night. In the case of painless,Patients can carry out the plan of early activity.Promote the recovery of gastrointestinal function.Early removal of Nasogastric tube reduces postoperative nausea and vomiting, throat discomfort and abdominal distension.Improve the nutritional status of patients, and promote early recovery of postoperative liver function in patients. Therefore, Systematic pain intervention combined early nutrition support accelerate the postoperative rehabilitation of the patients with primary liver cancer.