摘要
目的 探讨集束化护理干预在乳腺癌改良根治术患者康复中的应用效果,以改善患者生命质量,为乳腺癌改良根治术后康复护理提供参考依据.方法 2014年1月—2015年4月选择广西医科大学第四附属医院乳腺外科195例行乳腺癌改良根治术的患者,按随机分组法分成试验组97例,对照组98例,对照组实施乳腺癌常规护理,试验组采用集束化护理干预.比较两组患者术后皮下积液、皮瓣坏死、上肢水肿、出血的发生情况,患肢外展、后伸时关节活动度及乳腺癌患者生命质量状况.结果 试验组术后皮下积液17例,上肢水肿19例,对照组术后皮下积液20例,上肢水肿22例,试验组并发症发生情况少于对照组,差异有统计学意义（χ2值分别为12.311、14.030;P〈0.01）.术后4周、12周试验组患者关节活动度患肢外展度数分别为（130.01±6.16）°、（135.51±4.65）°,后伸度数分别为（38.92±4.28）°、（39.53±4.02）°,对照组患者关节活动度患肢外展度数分别为（128.18±7.35）°、（130.04±6.11）°,后伸度数分别为（36.61±4.13）°、（38.99±4.63）°,术后4周、12周两组数值在时间、组、组和时间的交互作用,差异均有统计学意义（P〈0.05）.术后6月、12月试验组乳腺癌患者生命质量测定量功能状况得分情况分别为（16.80±3.29）、（19.00±2.27）分,附加关注得分情况分别为（21.95±3.39）、（22.24±3.06）分,对照组乳腺癌患者生命质量测定量功能状况得分情况分别为（14.20±3.39）、（15.59±2.91）分,附加关注得分情况分别为（20.55±3.34）、（20.96±2.79）分,在术后6月、12月两组患者时间、组、组和时间的交互作用,差异均有统计学意义（P〈0.05）.结论 集束化护理干预对乳腺癌改良根治术患者康复效果明显优于传统的常规护理方法.
Objective To explore application of bundles of care intervention in rehabilitation of pa-tients with breast cancer after radical mastectomy （BCARM）, so as to improve the patients＆#39; quality of life, and to provide reference basis for rehabilitation nursing for patients with BCARM.Methods A total of 195 cases with BCARM treated in Department of Breast Surgery, the Fourth Affiliated Hospital of Guangxi Medical University from January 2014 to April 2015 were selected and divided randomly into experiment group with 97 cases and control group with 98 cases. Patients in the control group received routine care for breast cancer, while those in the experimental group received bundles of care intervention. Incidence of postoperative subcutaneous effu-sion, skin flap nectosis, upper limb edema, and bleeding of patients in the two groups were compared, together with motion range of joints in the affected limb when extending outward and backward, and quality of life of the patients.Results After the surgery, subcutaneous effusion occurred to 17 patients in the experiment group, and upper limb edema to 19, which were obviously less than that in the control group, with subcutaneous effusion to 20 and upper limb edema to 22 （χ2 =12.311, 14.030;P〈0.01）. 4 weeks and 12 weeks after the surgery, outward extending degree of the affected limb in the experiment group were （130.01±6.16）° and （135.51±4.65）° , and the backward extending degree （38.92±4.28）° and （39.53±4.02）° , obviously better than that in the control group, with outward extending degree of （128.18±7.35）°, （130.04±6.11）°, and backward extending degree of （36.61±4.13）° and （38.99±4.63）°. At 4 weeks and 12 weeks after the surgery, there was statistical difference between numbers of the time points, groups, and interaction between the groups and time （P〈0.05）. At 6 months and 12 months after the surgery, the measured scores of quality of life in the experiment group were （16.80±3.29） points and （19.
作者
刘小春
张艳霞
王楠楠
孙苹
韦佩沂
Liu Xiaochun Zhang Yanxia Wang Nannan Sun Ping Wei Peiyi(Nursing Department, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China Breast Department, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China)
出处
《中华现代护理杂志》
2017年第13期1752-1756,共5页
Chinese Journal of Modern Nursing
基金
广西壮族自治区卫生厅自筹经费科研计划课题（Z2014403）
关键词
乳腺肿瘤
康复
集束化护理干预
乳腺癌改良根治术
Breast neoplasms
Rehabilitation
Bundles of care intervention
Breast cancer after modified radical mastectomy
