以质量求发展，以服务铸品牌

Journal of Nursing ›› 2023, Vol. 30 ›› Issue (17): 67-72.doi: 10.16460/j.issn1008-9969.2023.17.067

Previous Articles     Next Articles

Construction and implementation of clinical nursing pathway for gastrointestinal function recovery in patients after pancreaticoduodenectomy

XU Yong-li, CAI Shao-ru, MAO Hui-na, QIU Jian-xia, LIANG Jing-hua   

  1. Dept. of Hepatobiliary Surgery II, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
  • Received:2023-03-15 Online:2023-09-10 Published:2023-10-11

PDF (PC)

85

Like

Abstract: Objective To construct a clinical nursing pathway for gastrointestinal function recovery after pancreaticoduodenectomy (PD) and to evaluate its clinical effect. Methods A clinical nursing pathway group was established and a clinical nursing pathway for gastrointestinal function recovery after PD were formed. The clinical data of 30 patients after PD in the hepatobiliary surgery nursing unit from February 2022 to December 2022 were retrospectively analyzed, which were given postoperative care according to the nursing pathway (intervention group). A total of 30 PD patients receiving routine care after pancreaticoduodenectomy from January 2021 to December 2021 were selected as historical controls (control group). The effects of the two nursing methods on the recovery time of bowel sounds, the time of the first postoperative anal exhaust, the time of the first postoperative defecation, the time of postoperative gastric tube indwelling and the average postoperative hospital stay were compared. Results After the implementation of the clinical nursing pathway, postoperative recovery time of bowel sounds (45.0±10.6 vs 58.2±18.7), postoperative first anal exhaust time (48.0±10.9 vs 63.0±18.6), postoperative first defecation time (66.6±14.4 vs 90.0±23.1), postoperative gastric tube indwelling time (73.0±33.3 vs 100.5±49.9) and postoperative average hospital stay (13.5±5.2 vs 16.6±4.5) in intervention group were shorter than those in the control group, and the differences were statistically significant (P<0.05). Conclusion PD nursing pathway can promote postoperative recovery of gastrointestinal function and rehabilitation.

Key words: pancreaticoduodenectomy, gastrointestinal function, clinical nursing pathway

CLC Number: 

  • R473.6
[1] 张玲,唐雯洁.假饲联合规范化抬臀运动在胰十二指肠切除术后患者中的应用[J].解放军护理杂志,2020,37(11):90-92.DOI:10.3969/j.issn.1008-9993.2020.11.024.
[2] 中华医学会外科学分会胰腺外科学组,中华医学会肠外肠内营养学分会.胰腺外科围术期全程化营养管理中国专家共识(2020版)[J].中华消化外科杂志,2020,19(10):1013-1029.DOI:10.3760/cma.j.cn115610-20200902-005
[3] 徐雪蕾,刘玮楠,马玉芬.腹腔镜胰腺手术患者消化功能恢复的预见性护理[J].护理学报,2017,24(3):60-61. DOI:10.16460/j.issn1008-9969.2017.03.060.
[4] 卢海燕,洪华丽,黄惠瑶,等.角膜塑形术患儿用眼健康行为的临床护理路径[J].护理学报,2019,26(19):57-62. DOI:10.16460/j.issn1008-9969.2019.19.057.
[5] 李偲,刘克玄,邓小明,等.术后胃肠功能障碍防治专家共识[J].国际麻醉学与复苏杂志, 2021, 42(11):1133-1142.DOI:10.3760/cma.j.cn321761-20210811-10003.
[6] 临床路径编委会.临床路径管理汇编[M].北京:科学技术出版社,2010:19-37.
[7] 汪梅,赵俊峰,吕锡丽,等.经尿道前列腺电切术后膀胱痉挛患者中医临床护理路径的构建[J].护士进修杂志,2021,36(19):1735-1738.DOI:10.16821/j.cnki.hsjx.2021.19.002.
[8] 中华医学会外科学分会,中华医学会麻醉学分会.加速康复外科中国专家共识及路径管理指南(2018版)[J].中国实用外科杂志,2018,38(1):1-20. DOI:10.19538/j.cjps.issn1005-2208.2018.01.01.
[9] 中华医学会外科学分会,中华医学会麻醉学分会.中国加速康复外科临床实践指南(2021)(三)[J].中华麻醉学杂志,2021, 41(9):1044-1052.DOI:10.3760/cma.j.cn131073.2021000904.
[10] Kleive D,Sahakyan MA,Labori KJ,et al.Nasogastric tube on demand is rarely necessary after pancreatoduodenectomy within an enhanced recovery pathway[J]. World J Surg,2019,43:2616-2622.DOI:10.1007/s00268-019-05045-4.
[1] TONG Zhi-lan, JIA Xue-qin, ZHANG Qi-mei. Nursing Cooperation in Laparoscopic Pancreaticoduodenectomy Combined with Vascular Reconstruction: A 11-case Study [J]. Journal of Nursing, 2022, 29(13): 71-73.
[2] LU Hai-yan, HONG Hua-li, HUANG Hui-yao, WANG Ying, XIAO Xin, LAN Fang-fang. Effect of Clinical Nursing Pathway on Eye Health of Children after Orthokeratology [J]. Journal of Nursing, 2019, 26(19): 57-62.
[3] HU Li-li, LIU Yi-su, LI Jia, WANG Le, ZENG Ying-hui. Effect of External Application of Glauber's Salt of Umbilical Cord and Point Massage of Zusanli on Postoperative Gastrointestinal Function in Patients Undergoing Laparoscopic Hepatectomy [J]. Journal of Nursing, 2019, 26(1): 5-7.
[4] GUO Qing-hua ,ZHENG Ming-lan ,HE Guang-lian ,GUAN Yu-lan . Effect of Hot Compress on Abdomen Based on Midnight-noon Ebb-flow on Gastrointestinal Function of Patients with Abdominal Operation in Gynecology Department [J]. Journal of Nursing, 2017, 24(20): 51-53.
[5] . Influence of Acupoint Therapy with Simo Decoction on Postoperative Gastrointestinal Function Recovery of Primary Liver Cancer Patients [J]. Journal of Nursing, 2013, (5): 53-55.
Viewed
Full text


Abstract

Cited
  Shared   
[1] WANG Ruo-xian, HE Bin, Wang Yu-huan, LIU Ke-ru, TANG Xue-ting, ZHAO Shu-hua, WEI Shan-shan. Current status and influencing factors of osteoporotic fracture risk perception bias in community elderly people[J]. Journal of Nursing, 2023, 30(15): 1 -5 .
[2] Wang Li-mei, Li Lu, Yu Peng, Luo Qian, Zhang Chong-ni. Status quo of medical narrative ability of nursing postgraduates and its influencing factors: a 237-case study[J]. Journal of Nursing, 2023, 30(17): 1 -4 .
[3] LI Na, HUANG Yi-xin, LIU Mei-lan, DENG Yin-hui, ZOU Xiao-fang. Translation of Health-promoting Behavior of Elderly People Scale and its reliability and validity[J]. Journal of Nursing, 2023, 30(17): 5 -10 .
[4] NING Yan-jiao, XU Guo-hui, FENG Ya-jing, YANG Jia-qi, WANG Hua-rong, SHAN Wei-ying. Construction of evaluation index system for clinical practice ability of new nurses[J]. Journal of Nursing, 2023, 30(17): 11 -15 .
[5] . [J]. Journal of Nursing, 2023, 30(17): 16 -19 .
[6] XUE Cui-cui, TENG Hong-xu, ZHANG Rong, LIU Hua-ping, TIAN Jian-li. Policies for sinking of high-quality nursing resources in China: a textual analysis[J]. Journal of Nursing, 2023, 30(17): 20 -23 .
[7] LIU Yu-jia, LU Fang, LIU Rui-yun. Policy research on elderly care workers in national pilot cities with integrated medical and elderly care services: a policy tool perspective[J]. Journal of Nursing, 2023, 30(17): 24 -28 .
[8] . [J]. Journal of Nursing, 2023, 30(17): 29 -33 .
[9] . [J]. Journal of Nursing, 2023, 30(17): 34 -38 .
[10] CHEN Ran, LI Chun-yu, LI Mei-qian. Defining polypharmacy based on Rodgers’ evolutionary concept analysis[J]. Journal of Nursing, 2023, 30(17): 39 -44 .