围手术期自我管理教育和行为干预对非小细胞肺癌患者预后的影响

目的探讨围手术期自我管理教育和行为干预对非小细胞肺癌患者预后的影响。方法 150例肺癌患者根据入院编号的单双号分为治疗组和对照组,每组75例。所有患者均实施肺癌肺叶切除术,对照组患者在围手术期行常规护理干预,治疗组患者在常规护理干预基础上实施自我管理教育与行为干预。结果两组患者术前最大通气量(MVV)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)和血清皮质醇含量对比,差异无统计学意义(P>0.05),而治疗组患者术后的MVV、FVC、FEV1值明显高于对照组,血清皮质醇含量低于对照组,差异均有统计学意义(P<0.05)。与对照组患者相比,治疗组患者出院时的生理智能、躯体疼痛、生理功能及总体健康评分明显高于对照组,差异有统计学意义(P<0.05)。治疗组患者术后肺不张和肺炎的发生率都明显低于对照组,差异有统计学意义(P<0.05)。结论围手术期自我管理教育与行为干预可有效缓解非小细胞肺癌患者应激反应,促进恢复肺功能,降低术后并发症,提高患者的生活质量。

Prognosis effects of perioperative self-management education and behavioral intervention for the pa- tients with non-small cell lung cancer

Objective To investigate the clinial value of perioperative self-management education and behavioral intervention for the patients with non-small cell lung cancer. Methods According to admission numbers based on odd and even numbers, a total of 150 lung cancer patients were equally divided treat- ment group and control group. All cases were given lung lobectomy, and the control group were underwent routine perioperative nursing intervention, the treatment group were added the perioperative serf-management education and behavioral intervention. Results The preoperative maximal voluntary ventilation （MVV）, forced vital capacity （FVC）, forced expiratory volume in one second （FEV1） values and serum cortisol lev- els compared between the two groups showed no significant difference, while the postoperative MVV, FVC, FEV1 values of the treatment group were significantly higher than the control group, and the serum cortisol levels in the treatment group were significant lower than the control group （ P 〈 0. 05 ）. The physiological function, physical function, bodily pain and general health scores of the treatment group at discharge time were significantly higher, with significant differences （P 〈0. 05 ）. The postoperative atelectasis incidence of pneumonia of the treatment group were significantly lower than the control group, with significant differences （ P 〈 0. 05 ）. Conclusion Perioperative self-management education and behavioral intervention in the nonsmall cell lung cancer patients can effectively relieve stress response and promote the recovery of lung function and has litter complications, it can reduce complications and improve the quality of life.