NNN-链接护理在乳腺癌患者乳房重建围手术期的效果

NNN-Link nursing in patients with breast reconstruction during the perioperative period

目的探讨NANDA-NOC-NIC(NNN)-链接护理在乳腺癌患者乳房重建围手术期的效果。方法选取2020年1月至2021年10月期间郑州大学附属肿瘤医院收治的168例异体乳房重建术的乳腺癌患者为研究对象, 采用随机数字表法分为两组, 各84例。对照组和观察组均给予围术期常规干预, 观察组同时联合NNN-链接护理干预。比较两组的围术期情况、术后不同时刻的视觉模拟疼痛(VAS)评分、自卑量表评分、自我感受负担量表(SPBS)评分和并发症情况。结果两组的手术失血量[(142.27±28.76) ml比(145.79±30.61) ml]和手术时间[(97.35±15.36) min比(93.89±13.67) min]比较差异无统计学意义(P>0.05);观察组的术后引流液总量[(208.49±26.49) ml]、术后引流管保留时间[(4.77±1.38) d]、进食时间[(11.58±1.89) h]、下床活动时间[(19.62±2.11) h]、住院时间[(5.18±0.97) d]均短于对照组[(312.67±30.78) ml、(7.89±1.65) d、(19.62±2.11) h、(35.81±4.87) h、(7.82±1.33) d], 差异有统计学意义(P<0.05)。术后1~5 d内两组的VAS、自卑量表、SPBS评分均逐渐降低, 且术后1、3、5 d时观察组的VAS[(5.09±0.80)、(4.34±0.77)、(3.46±0.77)分]、自卑量表(自评、外貌、社交、学习评分)、SPBS评分[(29.57±5.29)、(22.57±4.34)、(15.24±3.25)分]均低于对照组[(5.94±0.88)、(5.14±0.99)、(4.21±0.98)、(29.31±5.29)、(23.40±5.01)、(18.70±4.00)分], 差异有统计学意义(P<0.05)。观察组围术期感染、胃肠道问题、疼痛和尿潴留等各项并发症为11.09%的总发生率均低于对照组的33.33%, 差异有统计学意义(P<0.05)。结论 NNN-链接护理干预用于乳房重建术患者能够改善围手术期疼痛及并发症的发生, 促进康复, 同时还能够改善术后疼痛、自卑及自我感受负担。

Objective To explore the effect of NANDA-NOC-NIC(NNN)-linked nursing in breast cancer patients during the perioperative period of breast reconstruction.Methods A total of 168 breast cancer patients with allogeneic breast reconstruction admitted to our hospital from January 2020 to October 2021 were selected as the research objects.They were divided into two groups by random number table method,with 84 cases in each group.The control group and the observation group were given perioperative routine intervention,while the observation group was subjected to NNN-linked nursing intervention additionally.The perioperative conditions,visual analog pain(VAS)scores,inferiority scale scores,self-perceived burden scale(SPBS)scores and complications were compared between the two groups.Results There was no significant difference in the amount of surgical blood loss[(142.27±28.76)ml vs.(145.79±30.61)ml]and operation time[(97.35±15.36)min vs.(93.89±13.67)min]between the two groups(P>0.05).The total amount of drainage fluid[(208.49±26.49)ml],postoperative drainage tube retention time[(4.77±1.38)d],eating time[(11.58±1.89)h],time to get out of bed[(19.62±2.11)h],hospital stay[(5.18±0.97)d]were significantly reduced in observation group as compared with those in the control group[(312.67±30.78)ml,(7.89±1.65)d,(19.62±2.11)h,(35.81±4.87)h,(7.82±1.33)d](P<0.05).The VAS,inferiority complex scale and SPBS scores of the two groups gradually decreased within 1-5 d after operation,and the VAS of the observation group at 1,3,5 d after operation was(5.09±0.80),(4.34±0.77),(3.46±0.77)points,inferiority scale(self-assessment,appearance,social interaction,learning score),SPBS score[(29.57±5.29),(22.57±4.34),(15.24±3.25)points]were significantly lower than those of the control group[(5.94±0.88),(5.14±0.99),(4.21±0.98),(29.31±5.29),(23.40±5.01),(18.70±4.00)points](P<0.05).The total incidence of perioperative infection,gastrointestinal problems,pain,and urinary retention in the observation group was 11.09%,significantly lower than that in the control group(33.33%)(P<0.05).Conclusion NNN-linked nursing intervention for breast reconstruction patients can improve the occurrence of perioperative pain and complications,promote rehabilitation,but also can improve postoperative pain,inferiority and self-perceived burden.