综合干预措施对ICU肺癌术后患者睡眠质量的影响

Effect of comprehensive intervention on sleep quality of ICU postoperative patients with lung cancer

目的:为了进一步提高ICU肺癌术后患者睡眠质量,促进患者术后恢复,讨论综合干预措施对ICU肺癌术后患者睡眠质量的影响。方法:随机选取2015年6月-2017年12月期间在我院肿瘤科进行手术治疗且入住ICU的肺癌患者80例,随机分为观察组和对照组各40例,对照组患者治疗期间按照疾病护理常规开展常规护理工作,包括术前一天允许患者进入ICU病房熟悉环境;建立有效的护患沟通方式,给予心理支持;严密观察病情变化,协助患者采取舒适的卧位等。观察组患者在常规护理基础上采取综合干预措施;包括分区域放置患者,进行培训提高护士操作的熟练度及规范度、使用耳塞遮光眼罩等避免声光等干扰因素、进行耳穴压豆及穴位按摩等综合干预措施,对采取不同干预措施后的所有患者进行RCSQ睡眠量表评分。结果:观察组睡眠障碍发生率(5%)明显低于对照组患者(90%)。观察组与对照组患者RCSQ总分及各个条目(夜间睡眠深度、夜间入睡时间、夜间觉醒次数、夜间觉醒后重新入睡时间及夜间总体睡眠质量、ICU环境噪声)差异均有统计学意义(P <0.05),观察组的睡眠质量明显优于对照组。结论:综合干预措施可以明显改善ICU肺癌术后患者睡眠质量,促进伤口修复,预防并发症,有利于患者术后恢复,值得在临床中推广应用。

Objective: To discuss the effect of comprehensive intervention on the sleep quality of postoperative patients with ICU lung cancer with a prospect of further improving the sleep quality and to promote recovery. Methods: From June 2015 to December 2017, 80 patients with lung cancer were randomly divided into the observation group (n=40) and the control group (n=40). Patients in the control group were given routine nursing care during treatment, including allowing patients to enter the ICU ward one day before surgery to familiarize themselves with the environment;establish effective nurse-patient communication, give psychological support, closely observe the changes of the disease, assist patients to take comfortable lying position. The patients in the observation group took comprehensive intervention measures on the basis of routine nursing, including placing patients in different areas, training to improve the proficiency and standardization of nurses’ operation, and using ear plugs to avoid interference factors, such as optically and acousto-optic blindfolds, etc. All the patients who took different intervention measures were evaluated with RCSQ sleep scale. Results: The incidence of sleep disorder in the observation group was significantly lower than that in the control group. The total score of RCSQ and each item (depth of night sleep, time of falling asleep at night, times of awakening at night) in the observation group were compared with those in the control group. There were significant differences in the time of sleep and the total sleep quality (P<0.05). The sleep quality of the observation group was significantly better than that of the control group. Conclusions: Comprehensive intervention measures could significantly improve the sleep quality of patients with ICU lung cancer, promote wound repair, prevent complications, and help patients recover after operation, which was worth popularizing and applying in the clinical practice.