快速康复护理对胰十二指肠切除术患者血糖影响分析.docVIP

快速康复护理对胰十二指肠切除术患者血糖影响分析 　　摘要：目的 探讨快速康复护理对胰十二指肠切除术（Pancreaticoduodenectomy，PD）患者应激血糖水平及波动的影响。方法 选取2015年11月～2016年11月我院行PD手术患者58例，随机分为实施快速康复护理的观察组（29例）和实施常规护理的对照组（29例）。分析比较快速康复护理对两组患者PD术后1 d、3 d、7 d空腹血糖水平及术后5 d内平均血糖波动幅度的影响。结果 观察组患者PD术后1 d、3 d及7 d空腹血糖显著小于对照组（P0.05），而术后3 d、5 d观察组MAGE均显著小于对照组（P0.05）。结论 快速康复护理对PD术后患者应控制激性高血糖效果显著，值得推广应用。 　　关键词：快速康复护理；应激血糖；胰十二指肠切除术 　　中图分类号：R473.6 文献标识码：A 文章编号：1006-1959（2017）23-0150-02 　　Effect of Rapid Rehabilitation Nursing on Blood Glucose in Patients with Pancreaticoduodenectomy 　　YANG Yan 　　（Operation Room，Jiujiang First Peoples Hospital，Jiujiang 332000，Jiangxi，China） 　　Abstract：Objective To investigate the rapid rehabilitation nursing on pancreaticoduodenectomy（Pancreaticoduodenectomy，PD）effects of stress hyperglycemia and fluctuation of patients.Methods A total of 58 patients undergoing PD surgery in our hospital from November 2015 to November～2016 were randomly divided into the observation group（29 cases）with rapid rehabilitation nursing and the control group（29 cases）with routine nursing.The effects of rapid rehabilitation nursing on 1 d，3 d，7 d fasting blood glucose level and average blood glucose fluctuation within 5 d after operation were compared between two groups of patients after PD.Results The observation group patients after PD，1 d，3 d and 7 d fasting blood glucose was significantly less than the control group（P0.05），and after 3 d，5 d MAGE in the observation group were significantly lower than the control group（P0.05）.Conclusion The rapid rehabilitation nursing of postoperative patients with PD significantly induced hyperglycemia control effect，it is worthy of popularization and application. 　　Key words：Rapid rehabilitation care；Stress blood glucose；Pancreaticoduodenectomy 　　?g后快速康复护理是近年来逐步发展起来的一种多学科合作模式[1]，主要指在围手术期采用有循征医学证据的医疗措施，以期减少手术应激性反应，降低术后并发症发生率，进而减轻患者痛苦，缩短术后康复时间。不少临床研究已经证实，这一护理理念可以提高PD患者治疗效果和预后康复[2]。胰十二指肠切除术涉及切除胰腺、十二指肠等，影响十二指肠分泌肠促胰岛素激素、肠抑胃肽协助维持血糖稳定，从而使患者发生应激性高血糖。龙锦[3]等已证实了胰腺手术与患者围手术期空腹血糖水平的密切关系。目前，尚未见快速康复护理