综合干预措施对乳腺癌患者术后静脉血栓形成与肩关节功能的影响

Effect of comprehensive intervention measures on postoperative venous thrombosis and shoulder joint function in breast cancer patients

目的探讨综合干预措施对乳腺癌患者术后静脉血栓形成与肩关节功能的影响。方法收集2020年1月至2021年6月于绵阳市中心医院收治的118例乳腺癌患者的临床资料,将2020年1—9月采取常规干预措施的患者作为常规组,将2020年10月至2021年6月于常规干预措施的基础上采取综合干预措施的患者作为综合组,每组59例。比较两组患者干预前后心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)、医学应对方式问卷(MCMQ)评分]、生命质量[乳腺癌患者生命质量测定量表(FACT-B)评分]、肩关节活动功能(外展活动度、旋转活动度、上举活动度)。比较两组患者干预后舒适度(Kolcaba舒适状况量表评分)、满意度评分及术后并发症发生情况。结果干预后,综合组患者SAS、SDS、MCMQ中回避与屈服维度的评分均低于常规组患者,MCMQ中面对维度的评分高于常规组患者,差异均有统计学意义(P<0.05)。干预后,综合组患者FACT-B中生理状况、社会/家庭状况、情感状况、功能状况、附加关注维度的评分均高于常规组患者,差异均有统计学意义(P<0.05)。干预后,综合组患者的肩关节外展活动度、旋转活动度、上举角度均大于常规组患者,差异均有统计学意义(P<0.05)。综合组患者的Kolcaba舒适状况量表、满意度评分均高于常规组患者,差异均有统计学意义(P<0.05)。综合组患者术后并发症的总发生率低于常规组患者,差异均有统计学意义(P<0.05)。结论综合干预措施能够有效降低乳腺癌患者术后静脉血栓形成等并发症的发生风险,改善患者的肩关节功能及心理状态,提高患者的生命质量。

Objective To investigate the effect of comprehensive intervention measures on postoperative venous thrombosis and shoulder joint function in breast cancer patients.Method Data of 118 patients with breast cancer in Mianyang Central Hospital from January 2020 to June 2021 were selected.Among them,59 patients who received conventional intervention measures from January to September 2020 were included in the conventional group,and 59 patients who received comprehensive intervention measures from October 2020 to June 2021 were included in the comprehensive group.Psychological states[scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),medical coping modes questionaire(MCMQ)],quality of life[scores of functiond assessment of cancer therapy-breast cancer(FACT-B)],shoulder joint function(abductive range,rotational range and lifting range)between the two groups before and after intervention were compared.The comfort(Kolcaba comfort scale),satisfaction scores and incidence of postoperative complications between the two groups after intervention were compared.Result After intervention,scores of SAS,SDS,and avoidance and yield dimensional of MCMQ in comprehensive group were lower than those in the conventional group,and facing dimensional scores of MCMQ in comprehensive group were higher than that in the conventional group,and the differences were statistically significant(P<0.05).The physiological status,social/family status,emotional status,functional status and additional attention scores of FACT-B in comprehensive group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).After the intervention,the abductive range,rotational range and lifting range in the comprehensive group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).After the intervention,the scores of Kolcaba comfort scale and satisfaction in the comprehensive group were higher than those in the conventional group(P<0.05).The total incidence rate of postoperative complications in the comprehensive group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Comprehensive intervention measures can effectively reduce the risk of postoperative venous thrombosis in breast cancer patients,improve shoulder joint function,psychological state,and the quality of life of patients.