渐进式康复护理对脊柱肿瘤患者术后生活质量及心理状态的影响

Effect of progressive rehabilitation nursing on postoperative quality of life and mental status in patients with spinal tumours

目的探讨渐进式康复护理对脊柱肿瘤患者术后生存状况及心理状态的影响。方法选取2012年1月至2015年12月间十堰市人民医院收治的90例脊柱肿瘤患者,采用随机数表法分为观察组与对照组,每组45例。患者均行前后联合入路脊柱肿瘤切除术,术后观察组患者采用渐进式康复护理,对照组患者采用常规护理。分别于干预后1d、3d、5d和7d对两组患者采用视觉模拟评分法(VAS)进行疼痛评价,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者的焦虑和抑郁状态进行评价,并在干预前、干预后10d、1个月、3个月、6个月及9个月采用健康相关生命质量量表(HRQOL)对患者生存质量进行评价。结果观察组患者干预后1d和3d VAS评分均明显优于对照组,差异均有统计学意义(均P<0.05)。观察组患者干预后1d、3d和5d SAS及SDS评分均明显优于对照组,差异均有统计学意义(均P<0.05)。观察组患者干预后10d、1个月、3个月后及6个月后HRQOL评分均明显优于对照组,差异均有统计学意义(均P<0.05)。观察组患者生理指标、心理社会指标、性功能指标及医务人员关系指标均优于对照组患者,差异均有统计学意义(均P<0.05),观察组患者护理满意度为95.6%,高于对照组患者的82.2%,差异有统计学意义(P<0.05)。结论采用渐进式康复护理脊柱肿瘤术后患者,可有效改善患者焦虑和抑郁状态,提高生命质量及预后。

Objective To explore the effect of progressive rehabilitation nursing on the postoperative survival and mental status in patients with spinal tumors. Methods Ninety patients with spine tumors who underwent combined spinal and thoracic tumor resection at Shiyan People＇s Hospital from January 2012 to December 2015 were selected and randomly divided into an experimental group and a control group. Patients in the experimental group were given progressive rehabilitation nursing and patients in the control group were given routine nursing care. The patients were evaluated for pain using visual analogue scale（VAS） at 1,3,5 and 7 d after the intervention and self-rating anxiety scale（SAS） and self-rating depression scale（SDS） were used to evaluate anxiety and depression. Health related quality of life（HRQOL）was used to evaluate quality of life at 10 d,and 1 month,3 months,6 months and 9 months before and after the intervention,repectively. Results VAS scores were significantly better in the experimental group than in the control group at 1 d and 3 d after intervention（all P〈0. 05）. The scores of SAS and SDS were significantly better in the experimental group than those in the control group at 1 d,3 d and 5 d after the intervention（all P〈0. 05）. HRQOL scores were significantly better in the experimental group than in the control group at 10 d,and 1 month,3 months,6 months and 9 months after the intervention（all P〈0. 05）.Indicators of physiological,psychosocial,sexual function and relationship between patiehts and clinicians were better in the experimental group than in the control group（all P〈0. 05）. Conclusion The progressive rehabilitation nursing can improve patients＇ anxiety and depression effectively,quality of life and the prognosis in patients with spine tumors after operation.