Establishment And Application Research Of Perioperative Nursing Scheme For Liver Cancer Patients In Enhanced Recovery After Surgery

Objective: To establish the efficacy and safety of perioperative nursing scheme for patients with primary liver cancer after partial hepatectomy under enhanced recovery after surgery.Methods:1.According to the literature review,clinical investigation results and Delphi expert consultation method,a perioperative nursing scheme for liver cancer patients under enhanced recovery after surgery were established and applied to clinical practice.2.A total of 108 in-patients with liver cancer underwent hepatectomy from July2017 to December 2018.The patients were randomly divided into two groups: the control group(n=54)and the enhanced recovery after surgery group(ERAS group,n=54),control group using conventional nursing care,ERAS group used perioperative nursing scheme for patients under enhanced recovery after surgery.The scores of anxiety,pain and activity of daily living were compared in perioperative period between the two groups.The first time of feeding,get out of bed,exhaust and defecation,hospital stay time,incidence of complications,perioperative mortality,readmission rate within 30 days and total hospitalization cost were compared.Patients' and doctors' satisfaction with nursing work were compared.Results: 1.Perioperative nursing scheme for patients with liver cancer under enhanced recovery after surgery were established,including 3 first grade indexes,14 second grade indexes and 40 third grade indexes.2.Baseline results: there was no significant difference in sex,age,preoperative liver function reserve,tumor size,operation mode and duration of surgery between the two groups(P>0.05),with balanced comparability.3.The interention effect of perioperative nursing scheme for liver cancer patients under ERAS showed that: 1)Physical and mental recovery of patients during the perioperative period in the two groups:(1)The score of "anxiety" in the preoperative 1d,postoperative 1w and discharge from hospital was compared between the two groups,there were statistically significant(P<0.05).(2)The score of "pain" in the postoperative12 h,24h and 48 h were compared between the two groups,there were statistically significant(P<0.05).(3)The score of "activity of daily living" in the postoperative 1d,2d and 3d were compared between the two groups,there were statistically significant(P<0.05).2)The clinical outcome of the two groups: The first time of feeding,get out of bed,exhaust and defecation,incidence of complications,hospital stay time and hospitalization cost were compared between the two groups,there were statistically significant(P<0.05).3)Patients' and doctors' satisfaction on the nursing work were compared,there were statistically significant(P < 0.05).Conclusion: The perioperative nursing scheme for patients with liver cancer under enhanced recovery after surgery can alleviate the anxiety of patients,reduce postoperative pain,and improve the activity of daily living.It can promote the patients' early oral feeding and out of bed,accelerate the postoperative recovery of gastrointestinal function,reduce the postoperative complications,shorten the postoperative hospitalization time and reduce hospitalization cost.It also can improve the satisfaction of patients and doctors on nursing work.It is safe,effective and feasible in application of clinic.