循證護理在肝癌手術無瘤技術配合中的應用

張春花，樊儉

摘要：目的 ?探討循證護理在肝癌手術無瘤技術配合中的價值。方法 ?選擇2014年6月～2018年6月我院80例接受肝癌切除術患者作為研究對象，按照隨機數字表法分為對照組和觀察組，每組40例。對照組給予常規肝癌手術護理配合，觀察組循證護理基礎上無瘤技術配合，比較兩組腫瘤醫源性腹腔內或創面種植轉移發生率。結果 ?對照組術后出現3例腫瘤腹腔種植轉移，占7.50%;1例腫瘤肝臟創面轉移，占2.50%。觀察組未發現醫源性腹腔腫瘤種植和創面轉移病例。兩組腫瘤腹腔種植轉移及腫瘤肝臟創面轉移發生率比較，差異有統計學意義（P<0.05）。結論 ?循證指導下嚴格實施系列化無瘤技術，能夠有效防范醫源性腫瘤細胞播散及種植，改善預后。

關鍵詞：循證護理;肝癌手術;無瘤技術;護理配合

中圖分類號：R473 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻標識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2019.22.066

文章編號：1006-1959（2019）22-0185-03

Application of Evidence-based Nursing in the Technique of Tumor-free

Technique for Liver Cancer Surgery

ZHANG Chun-hua，FAN Jian

（Operation Room，Qidong People's Hospital，Qidong 226200，Jiangsu，China）

Abstract：Objective ?To explore the value of evidence-based nursing in the technical cooperation of liver cancer surgery. Methods ?From June 2014 to June 2018， 80 patients who underwent liver cancer resection in our hospital were selected as subjects. According to the random number table method， they were divided into control group and observation group， 40 cases in each group. The control group was given routine surgical treatment of liver cancer. The observation group was based on evidence-free nursing and combined with tumor-free technique. The incidence of iatrogenic intra-abdominal or wound implant metastasis was compared between the two groups. Results ?In the control group， 3 cases of tumor peritoneal metastasis occurred in the control group， accounting for 7.50%; 1 case of tumor liver metastasis， accounting for 2.50%. No cases of iatrogenic abdominal tumor implantation and wound metastasis were found in the observation group. There was a statistically significant difference in the incidence of tumor peritoneal metastasis and tumor liver metastasis between the two groups （P<0.05）. Conclusion ?Evidence-based strict implementation of serialized tumor-free technology can effectively prevent the spread and planting of iatrogenic tumor cells and improve the prognosis.

Key words：Evidence-based nursing;Liver cancer surgery;Tumor-free technology;Nursing cooperation

原發性肝癌（primary liver cancer）是我國常見惡性腫瘤之一，手術切除是肝癌治療的首選方案，但手術操作往往會增加腫瘤細胞醫源性播散的概率，直接影響患者的手術預后，因此術中必須高度重視無瘤技術的應用。循證護理是以現有最新、最可靠的科學證據為指導，做出最佳決策和護理實踐的新型工作模式。本研究選取2014年6月～2018年6月我院80例接受肝癌切除術患者，探討循證護理在肝癌手術無瘤技術配合中的價值，現報道如下。

1資料與方法

1.1一般資料 ?選擇2014年6月～2018年6月啟東市人民醫院80例接受肝癌切除術患者作為研究對象，納入標準：①腫瘤原發于肝臟，首次手術且符合肝癌診斷標準;②術中探查未發現腫瘤腹膜種植或肝內轉移;③有明確的肝癌病理學診斷。……