晚期肝癌患者肝动脉化疗栓塞术后预见性护理

Predictive care in patients with advanced liver cancer after TACE surgery

目的探究预见性护理对晚期肝癌患者肝动脉化疗栓塞术(TACE)术后并发症、心理状态、睡眠质量、生活质量的影响。方法选取医院2019年10月—2022年1月收治的行TACE的晚期肝癌患者86例为研究对象。按照组间基本特征具有可比性的原则分为对照组和观察组,每组43例,对照组TACE术后给予常规护理,观察组在对照组基础上给予预见性护理。比较两组术后并发症、心理状态、睡眠质量、生活质量及护理满意程度。结果观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。预见性护理前,两组SCL-90中抑郁、敌对、焦虑、偏执评分比较,差异无统计学意义(P>0.05);护理后,观察组SCL-90中抑郁、敌对、焦虑、偏执评分均低于对照组,差异均有统计学意义(P<0.05)。预见性护理前,两组QOL-C30中躯体功能、社会功能、心理功能、物质生活评分比较,差异无统计学意义(P>0.05);护理后,观察组QOL-C30中躯体功能、社会功能、心理功能、物质生活评分高于对照组,差异均有统计学意义(P<0.05)。预见性护理前,两组匹兹堡睡眠指数量表(PSQI)评分比较,差异无统计学意义(P>0.05);护理后,两组PSQI评分低于护理前,且观察组PSQI评分低于对照组,差异均有统计学意义(P<0.05)。观察组护理满意程度优于对照组,差异有统计学意义(P<0.05)。结论预见性护理改善晚期肝癌患者TACE术后心理状态,减少术后并发症,减轻患者睡眠障碍,改善生活质量,从而提高护理满意程度。

Objective To explore the impact of predictive care on postoperative complications,psychological status,sleep quality,and quality of life of advanced liver cancer patients undergoing transcatheter hepatic arterial chemoembolization(TACE).Methods A total of 86 patients with advanced liver cancer who underwent TACE and were admitted to the hospital from October 2019 to January 2022 were selected as the study subjects.According to the principle of comparability of basic characteristics between groups,the group was divided into a control group and an observation group,with 43 cases in each group.The control group received routine care after TACE surgery,while the observation group received predictive care on the basis of the control group to compare the postoperative complications,psychological status,sleep quality,quality of life,and nursing satisfaction between the two groups.Results The incidence of complication in the observation group was lower than that in the control group,and the diff erence was statistically signifi cant(P<0.05).Before predictive nursing,there was no statistically signifi cant diff erence in depression,hostility,anxiety,and paranoia scores between the two groups of SCL-90(P>0.05).After nursing,the SCL-90 scores of depression,hostility,anxiety,and paranoia in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before predictive nursing,there was no statistically signifi cant diff erence in physical function,social function,psychological function,and material life scores between the two groups of QOL-C30(P>0.05).After nursing,the QOL-C30 scores of physical function,social function,psychological function,and material life in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Before predictive nursing,there was no statistically signifi cant diff erence in Pittsburgh sleep quality index(PSQI)score between the two groups(P>0.05).After nursing,the PSQI scores of both groups were lower than before nursing,the PSQI score in the observation group was lower than that in the control group,and the diff erences were statistically signifi cant(P<0.05).The nursing satisfaction in the observation group was better than that in the control group,and the diff erence was statistically signifi cant(P<0.05).Conclusion Predictive nursing can improve the psychological state of late stage liver cancer patients after TACE surgery,reduce postoperative complications,alleviate sleep disorders,improve quality of life,and thus improve nursing satisfaction.