围术期护理对妇科肿瘤患者术后下肢静脉血栓和心理状况的影响

Effects of perioperative nursing care on lower extremity venous thrombosis and psychological status in patients with gynecologic neoplasms

目的探讨围术期护理干预对妇科肿瘤患者术后下肢静脉血栓和心理状况的影响。方法选取2012年1月至2016年6月间成都市第七人民医院收治的63例妇科肿瘤患者,采用随机数字表法分为研究组和对照组,研究组32例,对照组31例。研究组患者在常规护理基础上给予围术期护理,对照组患者采用常规护理。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价两组患者术前术后焦虑和抑郁情绪,记录患者术后下肢疼痛、肿胀和浅静脉曲张发生及采用B超测定是否出现栓子,采用生活质量量表对两组患者术后生活质量进行评价。结果手术前,两组患者焦虑、抑郁评分比较差异无统计学意义(P>0.05),手术后,研究组患者焦虑和抑郁情绪评分为(40.66±3.49)分和(40.74±3.48)分,显著低于对照组的(46.33±4.02)分和(45.93±4.03)分,差异均有统计学意义(均P<0.05)。护理干预前,两组患者生活质量比较差异无统计学意义(P>0.05),干预后,研究组患者生活质量评分较对照组高,差异有统计学意义(P<0.05)。对照组患者出现疼痛、肿胀、浅静脉曲张和B超测定出栓子,均高于研究组患者,差异有统计学意义(P<0.05)。结论围术期护理干预可以显著降低妇科肿瘤患者术后静脉血栓发生率,改善其心理状况,提高生活质量,值得临床推广。

Objective To study the effect of perioperative nursing intervention on lower extremity venous thrombosis and psychological status of patients with gynecologic tumors. Methods Sixty-three patients with gynecological cancer were selected at Chengdu Seventh People＇s Hospital from January 2012 to June 2016. Patients were randomly divided into a study group and a control group. The study group had 32 patients and the control group had 31 patients. The study group were given perioperative nursing care based on routine nursing and the control group only received routine nursing. Using self-rating anxiety scale（ SAS） and self-rating depression scale（ SDS） scale,anxiety and depression was evaluated in the two groups before and after surgery. Lower limb pain,swelling and superficial varicose veins after surgery were recorded and B-ultrasonography was used to detect embolus. Quality of life was evaluated by WHO QOL-100 scale. Results Before surgery,there was no significant difference in anxiety and depression score between the two groups（ P 0. 05）. After the operation,anxiety and depression scores was（ 40. 66 ± 3. 49） and（ 40. 74 ± 3. 48） respectively for the study group which was significantly higher than（ 46. 33 ± 4. 02,45. 93 ± 4. 03） of the control group（ all P 0. 05）. Before intervention,there was no significant difference in quality of life between the two groups of patients（ P 0. 05） but after the nursing intervention,quality of life score was higher in the study group than in the control group（ P 0. 05）. Incidence of pain,swelling,varicose vein and ultrasound detected emboli was higher in the control group than in the study group（ P 0. 05）. Conclusion Perioperative nursing intervention can significantly reduce the incidence of postoperative venous thrombosis,improve the psychological status and improve the quality of life,which is worthy of clinical application.