The Application Of Fast Track Surgery For Patients With Pancreatic Cancer Surgery In The Perioperative Period

ObjectiveTo discuss fast track surgury concept in pancreatic cancer patients perioperative nursing application effect。Observe the implementation of FTS concept on patients with postoperative intestinal function recovery, complications, the influence of the length of hospital stay and total cost, and compared with traditional perioperative management measures in order to verify its superiority, and finally proved it is practical and clinical significance in pancreatic cancer surgery field。MethodsChoose 70 cases of patients with pancreatic cancer who were hospitalized in Nanjing 3A-level hospital general surgury partment between January 2014 and October 2015, selected 35 patients from January to November 2014 as the control group, control group patients carry out the traditional perioperative nursing plan; 35 cases of patients from December 2014-October 2015 as FTS group, the FTS group adopt rapid rehabilitation surgery concept to improve the perioperative nursing。On two groups of patients, intraoperative indexes such as operation time、 infusion quantity、hemorrhage volume and urine were compared, also the two groups of patients compared with postoperative rehabilitation indicators such as patients with postoperative pain, for the first time the anus exhaust time, leave bed activity time, observe two groups of patients with postoperative complications, and finally compared patients hospitalized days and medical expenditure and the other economic indicators。ResultsThere was no statistically significant difference in patients with baseline data。(1)There was no statistical difference between two groups of operation time、blood loss in patients (P>0.05), but the FTS group of patients in infusion volume and urine amount is less than the control group(P<0.05)。(2)FTS group of patients with postoperative anal exhaust, the first defecation time is advanced than control group patients(P<0.01)。(3) FTS group compared with control group patients, postoperative diet and leave bed activity time greatly in advance for the first time(P<0.01)。(4) FTS group total complications were less than the control group, and patients with delayed gastric emptying rate is lower than the control group(P<0.05); But the other complications such as pancreatic leakage, abdominal cavity infection(arrhythmia, pneumonia, pleural effusion, nosocomial infection, etc) the incidence of differences between the two groups has no statistical significance (P>0.05)。(5)FTS group compared with control group,2、12 hours resting state postoperative and cough state VAS pain score difference was statistically significant(P<0.05),24、48 hours resting state and cough state VAS score differences between the two groups have no statistical significance (P>0.05), there was no statistically significant difference in first ambulation VAS pain score between the two groups (P>0.05)。(6) FTS was associated with a significant shorten hospitalization days compared with the control group patients, medical expense is less than the control group, the results have statistical significance(P<0.05)。Conclusion1. Apply FTS concept to perioperative nursing care of patients with pancreatic cancer is safe and effective。2.Compared with traditional perioperative nursing plan, FTS recommended perioperative care scheme can reduce the damage in patients with stimulation reactions and help patients recover from disrupted inherent physiological balance, and effectively relieve patient’s discomfort, and reduce the incidence of postoperative complications。3.The implementation of the fast track surgery can accelerate the recovery of bowel function after surgery for pancreatic cancer patients, and it can reduce postoperative pain and shorten the the first time that patient leave bed for activity and promote the recovery of patients’ overall state。4.The implementation of the fast track surgery can reduce pancreatic cancer patients with postoperative hospital stay without any increase in perioperative mortality, and speed up the hospital beds turnover, save patient’s health care spending, improve the quality of medical services。...