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24 February 2023: Clinical Research

Effects of Nursing Care Using a Fast-Track Surgery Approach in 49 Patients with Early-Stage Hepatocellular Carcinoma Undergoing First-Line Treatment with Radiofrequency Ablation: A Retrospective Study

Shuqi Zhang ABDE , Yanting Yang BD , Wen Liu AC , Bijin Yuan CD , Chunyan Tao AB , Guangjian Dou ACEFG*

DOI: 10.12659/MSM.939044

Med Sci Monit 2023; 29:e939044

Table 1 Comparison of nursing measures between the 2 groups.

Nursing measures2021 group2020 group
Health educationInform the fast recovery process about the preoperative fasting time, understand the surgical method and process, preoperative pulmonary function exercise, early postoperative activities, and expected discharge timeOnly inform patients about relevant surgical precautions
Psychological careWe accurately assessed the psychological state of patients of different ages and different family situations, and carried out pertinent psychological counselingThere was no aspect of psychological care involved
Bowel preparationNo intestinal preparation was required and 200–500 ml carbohydrate was given orally 2 hours before surgeryFasting the night before surgery
Intraoperative careDuring the operation, a warm blanket was used to keep patients warm, fluid infusion was limited, attention was paid to oxygen inhalation and oxygen saturation maintenance, blood pressure was maintained, and liver perfusion was ensured. After the operation, ropivacaine was injected into the skin around the puncture site for infiltrationRoutine rehydration without special measures
Pain careNon-steroidal analgesic drugs were given regularly and quantitatively, and the analgesic effect was known to the patients in time, and the reasons for poor analgesic effect were examined and dealt with. The pain assessment process was standardized and evaluated every 6 hours after surgeryTemporary analgesics are given when the patient was in pain
Early nutritionAfter surgery, chewing gum was used to stimulate saliva secretion and gastrointestinal motility, and a liquid diet could be given 6–8 hours after bowel sounds, without waiting for flatusChange to a liquid diet after first flatus and defecation
Early activityAfter waking up, patients were guided to move their limbs and turn over in bed to prevent the formation of deep vein thrombosis. At 6 h after the operation, patients were helped to get out of bed in the mode of “supine for 30 seconds – sitting up for 30 seconds – standing for 30 seconds” to prevent postural hypotension. With help from nursing staff, the activity time and activity amount were gradually increased with the patient’s recoveryBased on the patient’s own subjective wishes, the nurse guides the activities
Postoperative medicationProphylactic antibiotics were administered for 24 hours, hemostatic drugs were administered once after surgery, fluid replacement was limited according to dietary conditions, and sodium bicarbonate was used to alkalize urine to reduce the damage to renal function caused by surgical stressAntibiotics are routinely applied for 1–2 days, and antibiotics were upgraded according to body temperature and test indicators
Postoperative monitoringPostoperative blood routine, liver and kidney function, electrolytes, etc. were checked; vital signs were assessed every 60 minutes, and continuous monitoring was performed for 6 hours. After that, the measurement interval could be extended as prescribed by the doctor, and monitoring was stopped at 12 hours. After returning to the ward, we checked the bedside B-ultrasound for 2 hours. Re-examination was performed within 24 hours, and patients with no obvious abnormalities could be dischargedRoutine level I nursing monitoring for 3 days

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750