膀胱癌患者围手术期实施临床护理路径干预的效果

Efficacy of perioperative clinical nursing pathway-guided intervention in patients with bladder cancer

目的探讨膀胱癌患者围手术期实施临床护理路径干预的应用效果。方法选取2013年11月至2016年1月间四川省达州市中心医院行膀胱癌手术的132例膀胱癌患者,采用随机数表法分为观察组和对照组,每组66例。观察组患者采用临床护理路径干预,对照组患者采用常规护理干预。对两组患者术后指标、并发症发生率、护理效果、肿瘤复发率及生活质量评分等进行比较。结果观察组患者的下床活动时间、住院时间和住院费用均低于对照组患者,差异均有统计学意义(均P<0.05)。观察组并发症发生率为4.6%,低于对照组的16.7%,差异有统计学意义(P<0.05)。观察组患者护理满意度和健康知识知晓率均高于对照组患者,差异均有统计学意义(均P<0.05)。经1年随访观察,观察组患者肿瘤复发率和卡氏评分(KPS)分别为3.0%(2/66)和(83.98±6.86)分,对照组分别为12.1%(8/66)和(79.69±5.03)分,差异均有统计学意义(均P<0.05)。结论对膀胱癌患者围手术期实施临床护理路径干预,有良好的临床应用效果,能促进患者术后康复进程,减少术后并发症发生,提高护理满意度,降低肿瘤复发率,提高生活质量,可在临床上推广应用。

Objective To investigate the application of clinical nursing pathway-guided intervention for bladder cancer patients during perioperative period. Methods From November 2013 to January2016,132 patients with bladder cancer undergoing surgery at Dazhou Central Hospital were selected and randomly divided into an observation group a control group using a random number table with 66 patients in each group. The observation group received clinical nursing pathway-guided intervention and the control group was given routine nursing intervention in the perioperative period. The postoperative indexes,incidence of complications,nursing efficacy,recurrence rate and quality of life score were compared between the two groups. Results The ambulation time,hospitalization time and expenses were significantly lower in the observation group than in the control group（P〈0. 05）. The incidence of complications was 4. 6% for the observation group which was significantly lower than 16. 7% of the control group（P〈0. 05）. Patients＇ satisfaction with nursing and health knowledge awareness rate were significantly higher in the observation group than in the control group（all P〈0. 05）. During the 1-year follow-up period,the recurrence rate and KPS score was 3. 0%（2/66） and（83. 98 ± 6. 86） respectively for the observation group and 12. 1%（8/66） and（79. 69 ± 5. 03） respectively for the control group（all P〈0. 05）. Conclusion Perioperative clinical nursing pathway-guided intervention in patients with bladder cancer shows good efficacy,which can promote the rehabilitation process,reduce the risk of postoperative complications,improve nursing satisfaction of patients,reduce the recurrence rate and improve the quality of life and it can be widely applied in clinical practice.