摘要
目的探讨改良式颈胸加压带对经胸乳入路腔镜甲状腺癌手术患者止血效果和术后并发症的影响,为甲状腺癌术后护理提供参考。方法选择浙江大学医学院附属第二医院2018年10月至2019年10月收治的128例经胸乳入路腔镜甲状腺癌手术患者,按随机数字表法分为2组,每组64例,对照组术后采用宽胶布固定止血,试验组术后采用改良式颈胸加压带止血。记录2组患者术后并发症发生率,采用埃德蒙症状评估量表(ESAS)和Kolcaba舒适状况量表(GCQ)评估2组患者身体症状和舒适度。结果2组术前1 d ESAS、GCQ评分比较差异无统计学意义(P>0.05)。术后3 d,试验组ESAS中幸福感得分中位数为6.0分,明显高于对照组的4.0分,差异有统计学意义(Z值为2.919,P<0.01);术后3 d,试验组生理维度、心理维度、社会文化维度、环境维度及GCQ总分分别为(10.73±2.35)、(24.41±4.99)、(23.09±2.11)、(20.17±2.32)、(78.41±6.49)分,明显高于对照组的(8.41±2.23)、(22.42±4.79)、(21.22±2.73)、(19.20±2.97)、(71.25±6.92)分,差异有统计学意义(t值为2.058~6.031,P<0.05或0.01);试验组术后接触性皮炎、压力性紫癜、张力性水疱发生率分别为0、3.1%(2/64)、0,明显低于对照组的6.3%(4/64)、12.5%(8/64)、7.8%(5/64),差异有统计学意义(χ^(2)值为4.129、3.095、5.203,P<0.05)。结论改良式颈胸加压带可减轻腔镜甲状腺癌手术患者术后症状,降低皮肤损伤发生风险和提高患者的舒适度。
Objective To investigate the effect of modified cervicothoracic compression band on successful hemostasis and postoperative complications of patients with endoscopic radical thyroidectomy via breast areola approach and to provide reference for postoperative nursing of thyroid cancer.Methods A total of 128 patients with endoscopic radical thyroidectomy via breast areola approach from October 2018 to October 2019 in the Second Affiliated Hospital of Zhejiang University School of Medicine were selected and divided into experimental group(64 cases)and control group(64 cases)by random digits table method.Patients in the control group were fixed with wide adhesive tape for hemostasis,while patients in the experimental group wore modified cervicothoracic compression band.The postoperative complications between two groups were recorded,in addition,the physical condition and comfort of patients was assessed by Edmonton Symptom Assessment System(ESAS)and Kolcaba General Comfort Questionnaire(GCQ),respectively.Results There was no sigrificance in the score of ESAS,GCQ on the 1st day before the operation between the two groups(P>0.05).The median score of happiness in ESAS was 6.0 points in the experimental group on the 3rd day after the operation,significantly higher than 4.0 points in the control gorup,the difference was statistically significant(Z value was 2.919,P<0.01).The physiological,psychological,social,cultural and environmental comfort,total GCQ scores were(10.73±2.35),(24.41±4.99),(23.09±2.11),(20.17±2.32),(78.41±6.49)points in the experimental group and(8.41±2.23),(22.42±4.79),(21.22±2.73),(19.20±2.97),(71.25±6.92)points in the control group,the differences were statistically significant(t values were 2.058-6.031,P<0.05 or 0.01).The incidence of contact dermatitis,pressure purpura and tension blister were 0,3.1%(2/64),0 in the experimental group and 6.3%(4/64),12.5%(8/64),7.8%(5/64)in the control group,the differences were statistically significant(χ^(2) values were 4.129,3.095,5.203,P<0.05).Conclusion
作者
胡丹旦
倪小英
何建红
龚露丹
Hu Dandan;Ni Xiaoying;He Jianhong;Gong Ludan(Department of Thyroid Surgery,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)
出处
《中国实用护理杂志》
2021年第31期2401-2406,共6页
Chinese Journal of Practical Nursing
基金
浙江省教育厅一般科研项目(Y201838955)。
关键词
甲状腺肿瘤
颈胸加压带
经胸乳入路腔镜
舒适度
并发症
Thyroid neoplasms
Cervicothoracic compression band
Breast areola approach endoscopy
Comfort
Complication
