腹腔镜肾癌根治术患者围术期加速康复护理路径构建与应用

Construction and Application of Accelerated Rehabilitation Nursing Pathway during Perioperative Period for Laparoscopic Renal Cancer Radical Resection Patients

摘要: 目的：分析不同护理模式对腹腔镜肾癌根治术患者术后转归的差异化影响。方法：采用对照研究设计，将120例患者均衡分配至干预组与对照组。干预组接受整合性加速康复方案，涵盖术前营养优化、术中生理稳态维护及术后功能早期重建等措施链。对照组执行标准围术期护理流程。主要评估指标包括术后康复进程、并发症谱系及患者主观体验三个维度。结果：干预组在术后恢复指标方面表现优于对照组：首次排气时间平均提前15.8小时(P < 0.001)，住院时间缩短2.4天(P < 0.001)，下床活动时间提早2.4~3.6小时(P < 0.001)。并发症监测显示，干预组感染发生率降低10.0个百分点(P = 0.027)，深静脉血栓减少6.6个百分点(P = 0.037)，且未发生肠梗阻病例(P = 0.042)。患者体验方面，干预组疼痛评分降低1.4分(P < 0.001)，护理服务高评分比例提升36.6个百分点(P < 0.001)，健康知识掌握度提高14.3个百分点(P < 0.001)。结论：加速康复护理路径能够有效优化腹腔镜肾癌根治术患者的术后恢复进程，降低并发症风险，提升患者整体就医体验，具有临床推广价值。

Abstract: Objective: To analyze the differential effects of different nursing models on postoperative outcomes in laparoscopic renal cancer radical resection patients. Methods: A controlled study design was employed, with 120 patients evenly distributed between intervention and control groups. The intervention group received an integrated accelerated rehabilitation program encompassing preoperative nutritional optimization, intraoperative physiological stabilization, and early postoperative functional reconstruction. The control group followed standard perioperative care protocols. Key evaluation indicators included three dimensions: postoperative recovery progress, complication spectrum, and patient-reported experience. Results: The intervention group demonstrated superior postoperative recovery metrics compared to the control group: average first flatus time advanced by 15.8 hours (P < 0.001), hospital stay shortened by 2.4 days (P < 0.001), and ambulation time advanced by 2.4~3.6 hours (P < 0.001). Complication monitoring showed a 10.0% reduction in infection incidence (P = 0.027), decreased in deep vein thrombosis by 6.6 percentage points (P = 0.037), and no bowel obstruction cases reported (P = 0.042) in the intervention group. Regarding patient experience, the intervention group reported a 1.4-point decrease in pain scores (P < 0.001), increased proportion of high-rated nursing services by 36.6 percentage points (P < 0.001), and enhanced health knowledge mastery by 14.3 percentage points (P < 0.001). Conclusion: The accelerated rehabilitation nursing pathway can effectively optimize the postoperative recovery process of patients undergoing laparoscopic renal cancer radical resection, reduce the risk of complications, improve the overall medical experience of patients, and has clinical promotion value.