PDCA循环管理对经尿道膀胱肿瘤电切术后患者应激反应及生活质量的影响

Effect of PDCA Cycle Management on Stress Reaction and Quality of Life of Patients after Transurethral Resection of Bladder Tumor

目的探讨PDCA循环管理对经尿道膀胱肿瘤电切术后患者应激反应及生活质量的影响。方法选取2017年1月—2018年1月行经尿道膀胱肿瘤电切术的患者93例,随机分为对照组(46例,开展常规护理)和观察组(47例,开展PDCA循环管理),观察两组手术前后应激反应指标变化,包括皮质醇(Cor)、去甲肾上腺素(NA)、肾上腺素(AD),采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对患者手术前后心理状态进行评定,同时随访6个月,采用SF-36生活质量评分量表对患者手术前后生活质量进行评定。结果两组术后血清皮质醇、去甲肾上腺素、肾上腺素水平较术前均降低,但观察组术后应激反应指标均低于对照组(P <0. 05);两组术后SAS、SDS评分较术前均降低,但观察组术后VAS、SDS评分均低于对照组(P <0. 05);两组术后6个月生理功能、情感功能、社会功能、总体健康评分较术前均提高,但观察组术后生活质量评分高于对照组(P <0. 05)。结论 PDCA循环管理措施的实施,有利于减小经尿道膀胱肿瘤电切术后患者应激反应,同时有利于提高其生活质量。

Objective To explore the effect of PDCA circulation management on stress response and quality of life of patients after transurethral resection of bladder tumor. Methods 93 patients having undergone transurethral resection of bladder tumor from January 2017 to January 2018 in our hospital were selected and randomly divided into control group （ n =46） and observation group （ n =47）： the former was managed with routine nursing and the latter with PDCA cycle management. The stress response indexes of the two groups before and after operation were observed, including cortisol, norepinephrine and adrenaline. Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS） were used to assess the mental state of the patients before and after operation. Meanwhile, 6-month follow-up was performed and SF-36 quality of life scale was used to evaluate the quality of life of patients before and after surgery. Results The levels of serum cortisol, norepinephrine and adrenaline in both groups were lower than those before the operation, but the indexes of stress reaction in the observation group were significantly lower than those in the control group （ P 〈0.05）. The scores by SAS and SDS in the two groups were lower than those before the operation, but the scores of VAS and SDS in the observation group were signficanlty lower than those in the control group （ P 〈0.05）. The scores of physiological function, emotional function, social function and general health in the two groups were all improved 6 months after the operation, while the scores of quality of life in the observation group were higher than those in the control group （ P 〈0.05）. Conclusion The implementation of PDCA cycle management is conducive to reducing the stress response of patients after transurethral resection of bladder tumor, as well as beneficial for improving their quality of life.