自理能力评判对乳腺癌患者术后康复的影响

Effect of serf-care ability assessment on rehabilitation of patients after breast cancer operation

目的探讨自理能力评判对乳腺癌患者手术后康复的影响。方法选取2012年11月一2014年3月84例乳腺癌术后患者作为研究对象，按照随机数字表法将其分为观察组和对照组，每组各42例。对照组采取术后的常规护理，观察组在常规护理的基础上采取自理能力评判，以此指导生活护理及患肢功能锻炼。比较两组患者功能锻炼的依从性评分、住院时间、住院总费用及患侧肩关节的活动度。结果观察组患者术后功能锻炼依从性量表身体锻炼、术后注意事项、主动寻求建议3个维度的评分及总分分别为（29．8±5．5），（18．7±1．1），（13．8±1．2），（62．3±6．8）分，均高于对照组，差异有统计学意义（t值分别为3．802，5．340，8．574，6．292；P〈0．05）。观察组患者的住院时间为（14．1±0．7）d，住院总费用为（23635．4±2011．7）元，少于对照组，差异有统计学意义（f值分别为6．959，3．333；P〈0．05）。术后3个月，观察组患者的患侧肩关节屈、外展、后伸、内旋及外旋的活动度分别为（157．86±16．83）°，（152．374-23．15）°，（48．18±5．39）°，（62．33±6．80）°，（78．56±13．08）°，差异有统计学意义（t值分别为3．939，3．207，4．254，6．267，3．879；P〈0．05）。结论自理能力评判能提高乳腺癌术后患者功能锻炼的依从性，减少了住院时间以及经济压力，有利于患侧上肢的功能恢复。

Objective To investigate the effect of self-care ability assessment on rehabilitation of patients after breast cancer operation. Methods A total of 84 patients after breast cancer operation were randomly divided into observation group and control group on average. Patients in the control group were given conventional nursing care after operation. Based on it, patients in the observation group were given self-care ability assessment, which guided life care and functional exercise of affected limb. The scores of compliance of functional exercise, the length of stay, the total cost of hospitalization and the activity of affected shoulder were compared in the two groups. Results The scores of physical exercise dimension, post-operative notes dimension, initiative to seek advice dimension and total score of the compliance scale in the observation group were （29.8 ± 5.5 ）, （ 18.7 ± 1.1 ）, （ 13.8 ± 1.2）, （62.3 ± 6.8 ） , which were significantly higher than those of the control group （ t = 3. 802, 5. 340, 8. 574, 6.292, respectively; P 〈 0.05 ）. The length of stay and the total cost of hospitalization in the observation group were also significantly higher than these of the control group [ （ 14.1 _± O. 7） days vs （23 635.4 ± 2 O11.7） yuan ] （ t = 6. 959,3. 333, respectively; P 〈 0.05 ）. Three months after operation, the activity of flexion, abduction, extension, internal rotation and external rotation of the affected shoulder of the observation group were （157.86 ± 16.83）°, （152.37 _±23.15）°, （48.18 ±5.39）°, （62.33 _± 6.80） °, which were significantly higher than the control group （ t = 3. 939, 3. 207, 4. 254, 6. 267, 3. 879,respectively;P 〈 0.05）. Conclusions Self-care ability assessment can improve the functional exercise compliance of patients after breast cancer operation, reduce the length of hospitalization and economic pressure. It is beneficial to the recovery of affected upper hmb function as well.