围手术期综合护理对颜面部基底细胞癌患者术后疼痛和瘢痕美观度的影响

Effect of perioperative comprehensive nursing on postoperative pain and scar aesthetics in patients with facial basal cell carcinoma

目的探讨颜面部基底细胞癌患者应用围手术期综合护理干预的临床价值,并评估对其预后的影响。方法回顾性分析2020年1月至2021年12月武汉市第一医院收治的104例颜面部基底细胞癌患者的基线资料,按照护理措施的差异将其划分为对照组(54例)和观察组(50例)。对照组采取常规护理,在其基础上,观察组采取围手术期综合护理。对比2组患者的术后并发症、疼痛程度、负性情绪及瘢痕美观度。结果观察组的并发症总发生率(4.00%)低于对照组(16.67%,P<0.05)。2组在术后3 d、术后1周及出院时的视觉模拟评分法(VAS)评分均较同组入院时降低,术后1周及出院时的汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均较同组入院时降低;观察组在不同时间点的上述评分均较同期对照组更低,均存在统计学差异(P均<0.05)。出院1个月、3个月及6个月后,观察组的温哥华瘢痕量表(VSS)评分均较同期对照组更低(P均<0.05)。结论围术期综合护理干预可以有效缓解颜面部基底细胞癌患者的负性情绪,在减轻其疼痛程度的同时提升瘢痕美观度,并减少术后并发症。

Objective To explore the clinical value of perioperative comprehensive nursing intervention in patients with facial basal cell carcinoma,and to evaluate its impact on the prognosis.Methods A retrospective analysis was conducted on the baseline data of 104 patients with facial basal cell carcinoma admitted to Wuhan NO.1 Hospital from January 2020 to December 2021.They were divided into a control group(54 cases)and an observation group(50 cases)based on the differences in nursing measures.The control group received routine nursing,and the observation group additionally received perioperative comprehensive nursing.The postoperative complications,pain intensity,negative emotions,and scar aesthetics were compared between the two groups.Results The overall incidence of complications in the observation group was lower than that in the control group(4.00%vs.16.67%,P<0.05).In both groups,the Visual Analogue Scale(VAS)scores at 3 days,1 week after surgery and at discharge were lower than those at admission,and the Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)scores at 1 week after surgery and at discharge were lower than those at admission.The above scores of the observation group at different time points were lower than those of the control group,and there were statistical differences(all P<0.05).At 1,3,and 6 months after discharge,the Vancouver Scar Scale(VSS)scores of the observation group were lower than those of the control group(all P<0.05).Conclusion Perioperative comprehensive nursing intervention can effectively alleviate the negative emotions in patients with facial basal cell carcinoma,relieve the pain,improve the scar aesthetics,and reduce the postoperative complications.