系统护理干预配合腹腔镜前列腺癌根治术的临床效果

Clinical effect of systematic nursing intervention combined with laparoscopic aadical prostatectomy

目的 探索在围术期对施行腹腔镜下前列腺癌根治术的前列腺癌患者进行系统护理干预的临床效果。方法选取2014年5月~2016年4月期间于广州医科大学附属肿瘤医院施行腹腔镜下前列腺癌根治术的患者100例作为研究对象,按随机原则分为两组,每组50例。其中,对照组患者加以术前术后常规护理,观察组患者在围术期加以系统护理干预手段,观察并记录两组患者的术后24、48 h全身症状体征积分、入组时和术后1周的生活质量得分和住院满意度得分。所得数据采用统计学软件SPSS 21.0建模分析处理。结果 全部患者均顺利手术治疗。与对照组比较,观察组患者术后24 h全身症状、体征积分明显较低,差异有统计学意义（P〈0.05）,而两组患者的术后48 h全身症状、体征积分比较,差异无统计学意义（P〉0.05）;与入组时比较,观察组和对照组患者术后1周的功能量表、总体生活质量量表的各维度得分分别显著提高,差异均有统计学意义（P〈0.05）;术后1周,观察组患者在躯体功能、情绪功能、社会功能、总生活质量等四个量表的得分明显高于对照组,差异均有统计学意义（P〈0.05）;而在疲乏、疼痛、睡眠障碍等三个量表的得分方面,观察组则显著低于对照组,差异均有统计学意义（P〈0.05）。两组患者在角色功能、认知功能、呼吸困难和经济困难等四个量表方面比较,差异均无统计学意义（P〉0.05）;观察组患者在“服务与技术”、“关心与爱护”、“环境与指导”、“总体评价”及满意度总分方面均显著高于对照组,差异均有统计学意义（P〈0.05）。结论 在围术期进行全面的系统护理干预手段,不仅能加快患者术后症状恢复,而且还能提高患者生活质量和住院的满意度,值得临床上进一步优化推广。

Objective To explore the clinical effect of patients with prostate cancer who were performed systematic nursing intervention combined with laparoscopic radical prostatectomy in perioperative period. Methods 100 patients who were performed laparoscopic radical prostatectomy in Cancer Center of Guangzhou Medical University from May2014 to April 2016 were selected as research objects. They were divided into two groups according to randomized principle（50 cases each group）. Control group were given routine nursing before and after operation while observation were applied systematic nursing intervention in perioperative period. General symptom, sign integral after 24 h and 48 h,quality of life and satisfaction of inpatient score of the two groups one week after operation were record and observed.All the data were modeled and analyzed by software SPSS 21.0. Results All patients were performed successfully. General symptom and sign integral of observation group 24 h after operation were significantly lower than those of control group, the difference had statistical significance（P 0.05）. The difference had no statistical significance between two groups in general symptom and sign integral 48 h after operation（P 0.05）. All dimension scores of family function scale and global quality of life scale of the two groups one week after operation significantly improved when compared with at entering the group,the difference had statistical significance（P 0.05）. Observation group scored higher than control group in physical, emotional, social function and global quality of life one week after operation, the difference had statistical significance（P 0.05）. While observation group scored lower than control group in fatigue, pain and sleep disorders one week after operation and the difference had statistical significance（P 0.05）. The difference had no statistical significance in score of role function, cognitive function, dyspnea and economic difficulty（P 0.05）. Observation group scored higher than control group in service and technology, care and love, environment and guidance, comprehensive evaluation and satisfaction total score and the difference had statistical significance（P 0.05）. Conclusion Applying systematic nursing intervention in perioperative period can accelerate postoperative symptoms recovery and improve patients′ life quality and inpatient satisfaction and deserves further optimization and promotion.