强化护理干预对直肠癌经腹会阴联合切除术术后结肠造口患者的护理效果

Effect of intensive nursing intervention on colostomy patients after Miles Surgery for rectal cancer

目的探讨强化护理干预对直肠癌经腹会阴联合切除术(Miles)术后结肠造口患者造口并发症对心理状态、生命质量的影响。方法选择河北医科大学第三医院肛肠科2017年2月至2019年1月实施强化护理干预的直肠癌Miles术后结肠造口患者62例为观察组,选择2015年2月至2017年1月实施常规护理干预的直肠癌Miles术后的患者62例为对照组,比较2组术后3个月内造口并发症情况,干预前及干预3个月后心理状态(恐惧、抑郁、焦虑、敏感及强迫症状)、生命质量(躯体、认知、情绪、角色及社会功能)变化情况。结果观察组术后3个月内造口水肿、周围皮炎、表面出血、狭窄及脱垂等并发症总发生率为11.29%(7/62),低于对照组的37.10%(23/62),差异有统计学意义(χ2值为11.261,P<0.01)。观察组干预3个月后恐惧、抑郁、焦虑、敏感及强迫症状评分降低差值分别为(2.51±0.49)、(2.33±0.57)、(2.33±0.57)、(2.07±0.54)、(2.66±0.53)分,躯体、认知、情绪、角色及社会功能评分升高差值分别为(16.05±5.45)、(13.54±4.13)、(14.39±4.26)、(15.51±4.73)、(16.90±5.03)分,均显著高于对照组的(1.93±0.67)、(1.47±0.45)、(1.83±0.55)、(1.44±0.42)、(1.82±0.63)分和(9.23±3.25)、(8.21±2.44)、(9.08±3.13)、(6.89±2.25)、(7.35±2.17)分,2组比较差异有统计学意义(t值为4.263~13.730,P<0.01)。结论强化护理干预可显著减少直肠癌Miles术后结肠造口患者并发症,改善不良心理和情绪状态,提高者生命质量,临床护理效果满意。

Objective To explore the effect of intensive nursing mode on the nursing of colostomy complications of patients with rectal cancer after MILES and its influence on psychological status and quality of life.Methods 62 patients with colostomy after Miles operation were selected as the observation group,and 62 patients with Miles operation after Miles operation between February 2015 and January 2017 were selected as the control group.Comparisons of stoma complications within 3 months after operation were compared between the two groups.Changes of psychological status(fear,depression,anxiety,sensitivity and obsessive-compulsive symptoms),quality of life(physical,cognitive,emotional,role and social function)were compared before and after intervention.Results The total incidence of complications in the observation group was 11.29%(7/62),which was lower than that in the control group(37.10%(23/62).The difference was statistically significant(χ2 value was 11.261).After 3 months of operation,the scores of phobia,depression,anxiety,sensitivity and obsessive-compulsive symptoms decreased,and the scores of body,cognition,emotion,role and social function increased(P<0.05).After 3 months of operation,the scores of phobia,depression,anxiety,sensitivity and the scores of obsessive-compulsive symptoms were(2.51±0.49),(2.33±0.57),(2.33±0.57),(2.07±0.54),(2.66±0.53)and the scores of body,cognition,emotion,role and social function was(16.05±5.45),(13.54±4.13),(14.39±4.26),(15.51±4.73),(16.90±5.03)respectively,which were significantly higher than those of the control group(1.93)±0.67),(1.47±0.45),(1.83±0.55),(1.44±0.42),(1.82±0.63),and(9.23±3.25),(8.21±2.44),(9.08±3.13),(6.89±2.25),(7.35±2.17).The difference between the two groups was statistically significant(t values were 4.263-13.730,P<0.01).Conclusion Intensive nursing intervention can significantly reduce the complications of colostomy patients after Miles operation,improve the bad psychological and emotional state,improve the quality of life,and the clinical nursing effect is satisfactory.