基于智慧医疗系统的医护患一体化管理模式在预防乳腺癌术后淋巴水肿中的应用

Application of integrated medical and nursing management model based on intelligent medical system in preventing postoperative lymphedema of breast cancer

目的分析基于智慧医疗系统的医护患一体化管理模式在预防乳腺癌术后淋巴水肿中的应用效果。方法选择2018年7月至2019年8月南通大学附属医院甲乳外科接受乳腺癌腋窝淋巴结清扫术患者共180例,按照随机数字表法分为试验组和对照组各90例,最终试验组86例、对照组82例完成研究。对照组给予常规健康管理,试验组给予基于智慧医疗系统的医护患一体化管理模式。随访6个月,比较2组患者淋巴水肿认知水平、预防行为、淋巴水肿发生率、患者满意度。结果试验组淋巴水肿发病原因、临床表现、危险因素、预防方法、总体知晓率分别为82.56%(71/86)、84.88%(73/86)、83.72%(72/86)、83.72%(72/86)、83.72%(72/86),对照组分别为67.07%(55/82)、70.73%(58/82)、68.29%(56/82)、69.51%(57/82)、70.73%(58/82),2组比较差异有统计学意义(χ^(2)值为4.046~5.508,P<0.05)。试验组随访6个月皮肤护理、生活方式、避免上肢压迫、淋巴水肿预防行为总分分别为(9.54±1.04)、(30.45±2.45)、(9.35±1.08)、(58.92±8.20)分,对照组分别为(8.12±1.32)、(8.12±1.32)、(8.74±1.14)、(53.45±7.64)分,2组比较差异有统计学意义(t值为3.561~7.764,P<0.01)。试验组淋巴水肿发生率为9.30%(8/86),对照组为23.17%(19/82),2组比较差异有统计学意义(χ^(2)值为5.985,P<0.05)。试验组满意度为95.35%(82/86),对照组为82.93%(68/82),2组比较差异有统计学意义(χ^(2)值为6.771,P<0.01)。结论基于智慧医疗系统的医护患一体化管理有助于提高乳腺癌术后患者淋巴水肿认知水平,促进淋巴水肿预防行为的养成,减少术后淋巴水肿发生率,提高患者满意度。

Objective To analyze the application effect of integrated medical and nursing management model based on intelligent medical system in preventing postoperative breast cancer lymphedema.Methods A total of 180 patients undergoing axillary lymph node dissection for breast cancer were selected in the Affiliated Hospital of Nantong University from July 2018 to August 2019.According to the random number table method,they were divided into treatment group and control group for 90 cases in each group,and finally completed the study:86 cases in treatment group and 82 cases in control group.The control group was given routine health management,and the treatment group was given an integrated management model based on intelligent medical systems.After 6 months of follow-up,the two groups of patients were compared for their cognition of lymphedema,prevention behavior,incidence of lymphedema,and patient satisfaction.Results The incidence,clinical manifestations,risk factors,prevention methods,and overall awareness rates of lymphedema in the treatment group were 82.56%(71/86),84.88%(73/86),83.72%(72/86),83.72%(72/86),83.72%(72/86),and the control group were 67.07%(55/82),70.73%(58/82),68.29%(56/82),69.51%(57/82),70.73%(58/82),the differences were statistically significant(χ^(2) values were 4.046-5.508,P<0.05).The total scores of skin care,lifestyle,avoidance of upper limb compression,and prevention of lymphedema in the treatment group were(9.54±1.04),(30.45±2.45),(9.35±1.08),(58.92±8.20)points,and the control group were(8.12±1.32),(8.12±1.32),(8.74±1.14),(53.45±7.64)points,the differences were statistically significant(t values were 3.561-7.764,P<0.01).The incidence of lymphedema in the treatment group was 9.30%(8/86),and that in the control group was 23.17%(19/82),the difference was statistically significant(χ^(2) value was 5.985,P<0.05).Satisfaction was 95.35%(82/86)in the treatment group and 82.93%(68/82)in the control group,the difference was statistically significant(χ^(2) value was 6.771,P<0.01).Conclusions The integrated management of medical care and patients based on intelligent medical system can help improve the level of lymphedema cognition in patients with breast cancer surgery,promote the development of lymphedema prevention behavior,reduce the incidence of postoperative lymphedema,and improve patient satisfaction.