循证护理对进展期胃癌根治术患者治疗效果及生活质量的影响

Effect of evidence-based nursing on the efficacy and quality of life in patients with advanced gastric cancer undergoing radical resection

目的探讨循证护理对进展期胃癌根治术患者治疗效果及生活质量的影响。方法选取2015年9月至2016年9月间慈溪市第三人民医院收治的80例进展期胃癌根治术患者,按照入院顺序依次纳入观察组和对照组,每组40例,观察组患者给予循证护理,对照组患者给予常规护理。观察比较两组患者术后并发症发生情况,记录两组患者术后下床活动时间与住院时间。术后随访12个月,分别于治疗前和末次随访时,采用简明健康调查问卷(SF-36)对两组患者评估,并观察复发情况。结果观察组术后并发症发生率为7.5%,显著低于对照组的25.0%,差异有统计学意义(P<0.05)。观察组患者的下床活动时间和住院时间均显著短于对照组患者,差异均有统计学意义(均P<0.05)。观察组复发率为5.0%,显著低于对照组的20.0%,差异有统计学意义(P<0.05)。末次随访时,两组患者的生活质量与本组治疗前比较均得到明显改善,各项指标评分均明显提高,且观察组改善效果更为显著,末次随访时的不同指标评分均显著高于对照组,差异均有统计学意义(均P<0.05)。结论循证护理应用于进展期胃癌根治术患者临床护理之中,效果确切,可有效减少术后复发,降低术后并发症发生率,并有效改善患者的生活质量。

Objective To explore the effect of evidence-based nursing on efficacy and quality of life in patients with advanced gastric cancer undergoing radical resection. Methods Eighty patients undergoing radical gastrectomy for gastric cancer at Third People＇s Hospital of Cixi from September 2015 to September 2016 were selected. They were divided into an observation group and a control group according to the sequence of admission with 40 patients in each group. The observation group was given evidence-based nursing and the control group was given routine nursing. The postoperative complications of the two groups were compared,and time to out of bed activity and length of hospitalization were recorded in the two groups. The patients were followed up for 12 months. The patients in the two groups were evaluated by the simple health questionnaire（SF-36） before the treatment and after the last follow-up,and the recurrence was observed. Results The incidence of postoperative complications was 7. 5 % for the observation group which was lower than 25. 0 % of the control group（P〈0. 05）. The time to out of bed activity and length of hospitalization was shorter in the observation group than in the control group（all P〈0. 05）. Recurrence occurred in 2 patients in the observation group which was lower than in the control group（recurrence rate,5. 0 % versus 20. 0 %）（P〈0. 05）. At the end of the follow-up,the quality of life were significantly improved in the two groups compared with those before the treatment,the improvement in quality of life was significantly higher in the observation group than in the control group and the scores of different index was significantly higher in the observation group than in the control group at the last follow-up（all P〈0. 05）. Conclusion Evidence-based nursing is clinical effective in patients with advanced gastric cancer. It can effectively reduce postoperative recurrence and postoperative complication rate,and effectively improve the quality of life.