护理干预在直肠癌前切除术后并发吻合口瘘的应用及效果

目的：探讨护理干预在直肠癌前切除术后并发吻合口瘘的应用及效果。方法：将179例患者分为对照组和观察组，分别给予常规护理和综合护理，观察护理干预在直肠癌前切除术后并发吻合口瘘的应用效果。结果：对照组术后3 d内5例患者发生吻合口瘘，3例患者术后4-7 d发生吻合口瘘；观察组术后3 d内1例患者发生吻合口瘘，1例患者术后4-7 d发生吻合口瘘，两组吻合口发生率差异有统计学意义（x2=3.880，P＜0.05）。经过护理和治疗后，观察组患者吻合口瘘愈合时间明显短于对照组（t=4.026，P＜0.05）。对照组SAS 阳性率69.23%，观察组50.00%，二者之间具有统计学差异（x2=5.186，P＜0.05）；对照组SDS阳性率61.54%，观察组40.00%，二者之间具有统计学差异（x2=4.978，P＜0.05）。结论：合理有效的综合护理措施可以减少吻合口瘘和医患矛盾的发生，提高患者对治疗的满意度，促进医患关系的和谐。

The Application and Effect of Nursing Intervention on Anastomosis Fistulaafter Anterior Resection of Rectal Cancer

Objective:To explore the application and effect of nursing intervention on Anastomosis fistula after anterior resectionof rectal cancer.Methods:179 cases were divided into control group and observation group. Patients in control were given normal careand those in observation group were given comprehensive care. Observe the effect of nursing intervention on Anastomosis fistula afteranterior resection of rectal cancer.Results:In control group, 5 patients had anastomotic fistula within 3 days, and 3 patients had anastomoticfistula in 4-7 d after operation. In observation group, only one patient had anastomotic fistula within 3d after operation, and one hadin 4-7 d. The incidence rate of anastomotic fistula in observation group was significantly lower than in control group (x2=3.880, P<0.05).After nurse care and treatment, the time of anastomotic fistula healing in observation group was obviously shorter than that in controlgroup (t=4.026, P<0.05). The positive rate of SAS was 69.23%in control group but 50.00%in observation group; difference between thetwo groups had statistical significance (x2=5.186, P<0.05). The positive rate of SDS was 61.54%in control group but 40.00%in observationgroup, also with statistical difference (x2=4.978, P<0.05).Conclusion:Reasonable and effective comprehensive care could decreasethe incidence of the anastomotic fistula and conflict between doctors and patients. It can improve the satisfaction of patients to treatmentand can promote the harmony between patients and doctors.