标题：思维导图引导康复护理对胃癌根治术患者围术期的护理效果研究

      作者：郭瑞娟 1，汤文丽 2，刘洁 1，陈志惠 1，闫君 3，王丽娟 4    汉中市中心医院手术室 1、体检中心 2、门诊办 3、质量控制办公室 4，陕西 汉中 723000

      卷次： 2020年31卷20期

      【摘要】 目的 研究思维导图引导康复护理对胃癌根治术患者围术期的护理效果，为患者的护理提供指导。方法 选取 2016年 12月至 2018年 12月期间在汉中市中心医院接受腹腔镜胃癌根治术的 100例患者作为研究对象，按随机数表法将其分为观察组和对照组各50例。对照组患者行常规康复护理，观察组在对照组护理措施基础上采用思维导图进行康复护理引导。比较两组患者的胃管留置时间、肛门排气时间、首次进食时间、术后首次下床活动时间、住院时间和体质量下降水平；于术后2 h、12 h、24 h、48 h及初次下床活动时采用视觉模拟评分法(VAS)评估两组患者的疼痛情况；并比较两组患者的护理满意度及术后并发症发生情况。结果 观察组和对照组患者的胃管留置时间[(33.34±10.24) h vs (52.34±14.27) h]、肛门排气时间[(76.25±20.87) h vs (91.67±21.18) h]、首次进食时间[(45.19±13.53) h vs (96.13±26.20) h]、术后首次下床活动时间[(55.20±16.33) h vs (100.67±30.18) h]、住院时间[(13.81±2.53) d vs (18.13±5.29) d]和体质量下降[(3.15±0.18) kg vs (5.43±0.87) kg]比较，观察组明显短于或低于对照组，差异均具有统计学意义(P<0.05)；观察组患者术后 2 h、12 h、24 h、48 h及初次下床活动时VAS疼痛评分明显低于对照组，差异均有统计学意义(P<0.05)；观察组患者的护理满意度为98.0%，明显高于对照组的76.0%，术后并发症总发生率为10.0%，明显低于对照组的32.0%，差异均有统计学意义(P<0.05)。结论 思维导图引导康复护理方式在胃癌根治术患者围术期的临床护理效果显著，其不仅能使护理人员熟悉护理各项内容，提高护理工作质量，而且有利于缩短患者术后住院时间，降低患者术后疼痛程度和术后并发症发生率。
      【关键词】 腹腔镜胃癌根治术；思维导图；康复护理；应用效果；并发症
      【中图分类号】 R735.2 【文献标识码】 A 【文章编号】 1003—6350（2020）20—2717—04

Effect of mind map guided rehabilitation nursing on perioperative nursing of patients with gastric cancerundergoing radical surgery.
GUO Rui-juan 1, TANG Wen-li 2, LIU Jie 1, CHEN Zhi-hui 1, YAN Jun 3, WANG Li-juan 4.Operating Room 1, Physical Examination Center 2, Outpatient Office 3, Quality Control Office 4, Hanzhong Central Hospital,Hanzhong 723000, Shaanxi, CHINA
【Abstract】 Objective To study the effect of mind map guided rehabilitation nursing on perioperative nursingof patients undergoing radical gastrectomy for gastric cancer, and provide guidance for patients' nursing. Methods A to-tal of 100 patients who underwent laparoscopic radical gastrectomy in Hanzhong City Central Hospital from December2016 to December 2018 were selected as the research objects. They were divided into observation group and controlgroup according to random number table method, with 50 patients in each group. Patients in the control group receivedroutine rehabilitation nursing measures, and those in the observation group used mind maps to guide rehabilitation nurs-ing based on the nursing measures in the control group. The gastric tube indwelling time, anal exhaust time, first mealtime, first bedtime activity, hospitalization time and weight loss level were compared between the two groups. The visualanalogue scale (VAS) pain scoring method was used to evaluate the pain of the two groups of patients at 2 h, 12 h, 24 h,48 h and the first time of getting out of bed after operation. The nursing satisfaction and postoperative complications ofthe two groups were compared. Results The observation group was significantly shorter or lower than the controlgroup in the following indexes (P<0.05): gastric tube indwelling time, (33.34±10.24) h vs (52.34±14.27) h; anal exhausttime, (76.25±20.87) h vs (91.67±21.18) h; time of first eating, (45.19±13.53) h vs (96.13±26.20) h; the time of getting outof bed for the first time after surgery, (55.20±16.33) h vs (100.67±30.18) h; the length of hospital stay, (13.81±2.53) d vs(18.13±5.29) d; and weight loss, (3.15±0.18) kg vs (5.43±0.87) kg. The VAS pain scores and the time of getting out ofbed for the first time in the observation group were significantly lower than those of the control group at 2 h, 12 h, 24 h,48 h after surgery, and the differences were statistically significant (P<0.05). The nursing satisfaction of the observationgroup was 98.0%, which was significantly higher than 76.0% of the control group, and the total postoperative complica-tion rate was 10.0% , which was significantly lower than 32.0% of the control group (P<0.05). Conclusion Mindmap-guided rehabilitation nursing methods have significant clinical nursing effects in the perioperative period of patientsundergoing radical gastrectomy for gastric cancer. It can not only familiarize nursing staff with various nursing contents,improve the quality of nursing work, but also help shorten the postoperative hospital stay and reduce patients the degreeof postoperative pain and the