围手术期人文关怀护理对外阴癌患者生存生活质量的影响

Effect of perioperative humanistic care on the life quality of patients with vulvar cancer

目的探讨围手术期人文关怀护理对外阴癌患者自我保护能力、生活质量、术后并发症、生存状况的影响。方法选取2014年8月至2017年4月哈尔滨医科大学附属第二医院行外阴癌手术患者72例为研究对象,根据是否采取人文关怀护理把患者分为对照组(32例)与观察组(40例)。两组均行外阴广泛切除术+腹股沟淋巴结清扫术,对照组患者,提供传统护理,观察组患者在对照组护理基础上,提供人文关怀护理。结果护理后两组的健康知识水平、自我概念及自我责任感等均高于护理前,患者认知功能、躯体功能、总体健康等方面的评分均比护理前提高(P <0. 05),且观察组高于对照组(P <0. 05)。观察组术后1个月并发症发生率(5. 0%)低于对照组(25. 0%)(P <0. 05)。随访到2017年12月,观察组的平均生存期(57. 63±2. 13)月、平均无进展生存期(51. 23±1. 98)月,显著长于对照组[(41. 94±2. 89)月、(38. 81±2. 11)月](P <0. 05)。结论通过提供人文关怀护理可以极大提高患者的自我护理能力与生活质量,减少术后并发症的发生,延长患者的生存时间。

Objective To explore the influence of quality of life,self protection,postoperative complications and survival of humanistic care for patients with vulvar cancer in the perioperative period.Methods 72 cases of patients with external vulvar cancer surgery from The 2 nd Affiliated Hospital of Harbin Medical University from August 2014 to April 2017 were selected.According to whether humanistic care was taken,the patients were divided into control group and observation group,including 32 cases in the control group and 40 cases in the observation group.The two groups were treated with wide resection of vulva + inguinal lymph node sweep operation,the control group was given conventional nursing,the observation group was given humanistic care based on the control group’s nursing.Results After nursing,the scores of self-care skills,self responsibility,self-concept and health knowledge in the two groups were significantly higher than those before nursing,and the scores in the observation group after nursing were also higher than those in the control group(P<0.05).After nursing,the physical function,role function,cognitive function,emotional function,social function and general health score of observation group and control group were significantly higher than those before nursing(P<0.05),and the observation group was also significantly higher than that of control group(P<0.05).The postoperative1 month incidences of complications such as venous thrombosis,urinary tract infection,pulmonary infection and incision infection in the observation group was 5.0 %,while was 25.0 % in the control group,the observation group was significantly lower than that in the control group(P<0.05).Followed up to December 2017,the median survival time was(57.63±2.13) months and the median progression free survival time was(51.23±1.98) months in the observation group,which were significantly higher than those in the control group [(41.94±2.89) months and(38.81±2.11) months](P<0.05).Conclusion The application of humanistic care in perioperative period of vulva cancer can improve the quality of daily life and self-care ability,reduce postoperative complications and prolong the survival time of patients.