Objective:To explore the effects of an integrated clinical pathway model on the gastrointestinal function and complications in patients after pancreaticoduodenectomy (PD) .Methods:Totally 95 patients after PD admitted to the First Affiliated Hospital of Zhengzhou University from March 2018 to March 2020 were selected and divided into a control group (41 cases) and an observation group (54 cases) . Patients in the control group received routine clinical care pathway, while patients in the observation group received integrated clinical pathway. The indicators for postoperative gastrointestinal function recovery (postoperative bowel sound recovery, time of anal exhaust time, first time of defecation) , pancreatic fistula and other complications were compared between the two groups.Results:The postoperative bowel sound recovery time, time of anal exhaust, and first time of defecation in the observation group were shorter than those in the control group, and the differences were statistically significant ( P< 0.05) ; 10 patients in the observation group developed postoperative complications, accounting for an incidence rate of 18.52%, which was lower than 70.73% (29/41) in the control group, with statistically significant difference ( P< 0.05) . Conclusions:The postoperative gastrointestinal function of patients after PD who receive the integrated clinical pathway model recovers better and postoperative complications are reduced.

Objective:To explore and analyze the effect of staged rehabilitation combined with therapeutic communication system (TCS) intervention mode on postoperative mental state and quality of life of patients with gallbladder cancer.Methods:A total of 170 patients with gallbladder cancer admitted to the Second Department of Hepatobiliary and Pancreatic in the First Affiliated Hospital of Zhengzhou University from February 2019 to February 2020 were selected by convenience sampling method as the research objects, and were randomly divided into observation group ( n=86) and control group ( n=84) . Patients in the control group were given routine nursing, while patients in the observation group were given staged rehabilitation combined with TCS intervention mode. The scores of the MOS 36-Item Short-Form Health Survey (SF-36) , the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) before and after intervention, and the incidence of complications after intervention were compared. Results:After intervention, the SF-36 scores of the two groups were higher than those before operation, and the score of the observation group was higher than those of the control group, the differences were statistically significant ( P<0.01) . After intervention, the SAS and SDS scores of the two groups were lower than those before the intervention, and the scores of observation group were lower than those of the control group, the differences were statistically significant ( P<0.01) . The total incidence of postoperative complications in the observation group was 4.65% (4/86) , which was lower than 23.81% (20/84) in the control group. The difference was statistically significant ( P<0.01) . Conclusions:Staged rehabilitation combined with TCS intervention can effectively reduce the incidence of postoperative complications in patients with gallbladder cancer, improve the mental state of patients, and improve their quality of life.