人性照护理论在肿瘤患者化疗中的应用

目的 探讨在肿瘤患者化疗过程中应用人性照护理论对患者的影响.方法 将150例肿瘤患者随机分为干预组和对照组各75例.干预组实施依据人性照护理论制订的护理措施,对照组按传统的护理措施进行护理,比较2组患者依从性、药液外渗或静脉炎发生率.结果 干预组依从性、药液外渗或静脉炎发生率明显优于对照组.结论 实施依据人性照护理论制订的护理措施可以提高肿瘤患者化疗的依从性、对护理质量的满意度和生活质量,值得临床推广应用.

Abstract：

Objective To explore the role of the theory of human care in cancer patients during chemotherapy.Methods 150 patients with tumor undergoing chemotherapy were divided randomly into the intervention group and the control group (each had 75 cases).The intervention group took the human nursing care,the control group was applied with the traditional nursing method,compliance,liquid extravasation or phlebitis after chemotherapy were observed and compared.Results The compliance,incidence of liquid extravasation or phlebitis in the intervention group was significantly better than those of the control group.Conclusions Implementation of the nursing care based on human care theory can improve compliance of chemotherapy,satisfaction with the quality of care and quality of life in cancer patients,and hence is worthy of being recommended in clinical practice.     

运动训练对乳腺癌术后患者生活质量影响的临床研究

目的 探讨运动训练对乳腺癌术后患者生活质量的影响作用.方法 将156例乳腺癌术后患者随机分为研究组(80例)和对照组(76例).研究组在常规护理的同时采取运动训练干预,对照组只给予常规护理,1个月后分别观察两组患者患侧上肢的水肿情况,1年后分别应用健康状况调查问卷(SF-36中文版)对乳腺癌术后患者进行测定,评价两组患者的生活质量(QOL),并进行比较.结果 研究组患者患侧上肢水肿发生率明显较对照组低(P＜0.01);研究组SF-36量表的各项评分均明显高于对照组(P＜0.01).结论 运动训练可明显消除乳腺癌术后患者患侧上肢的水肿,增强患者治疗的信心,从而促进康复,达到提高乳腺癌术后患者生活质量的目的.

Abstract：

Objective To study the effect of exercise training on the quality of life (QOL) of postoperative breast cancer parients. Methods The 156 postoperative breast cancer patients were divided into observation group (80 cases) and control group (76 cases) . The control group was given routine nursing, and the observation group was given exercise training on the basis of routine nursing. The QOL of the all the patients were evaluated by SF - 36 after 1 year. Results The incidence of edema of the upper extremity in observation group was lower than that of control group, the scores of SF-36 of observation group were higher than those of control group. Conclusions Exercise training can reduce the edema of the upper extremity of postoperative breast cancer patients, and enhance of therapic confidence, promote rehabilitation, improve the postoperative breast cancer patients'life quality.     

护理干预对宫颈癌患者放疗后并发症的影响

Objective To investigate the nursing intervention on the complication after radiotherapy of cervical cancer patients.Methods A total of 130 cervical cancer patients undergoing radiotherapy were randomly divided into two groups:control group was given conventional methods only treatment and care,while the observation group was given additional routine treatment and care according to the situation in which two radiation therapy in patients with stages of psychological nursing,health education,guidance,individualized care and symptomatic treatment intervention,and then the number of cases of complications for the patients as well as the degree of satisfaction were compared.Results After the first phase of the second phase,the incidence of complications was significantiy lower in observation group than that of the control group,the degree of satisfaction was significantly higher (P＜0.05) .Conclusions The implementation of nursing intervention for cervical cancer patients undergoing radiotherapy can be effective in reducing the incidence of complications and improve patients' satisfaction.     

叙事护理对乳腺癌患者术后焦虑抑郁情绪及病耻感的影响分析

【 】 Objective To analyze the influence of narrative nursing on the bad mood and stigma of breast cancer patients. Methods Taking August 2021 to August 2022 as the time line, 60 patients with breast cancer who underwent surgery in our hospital during this period were selected as the research object. According to the order of admission, the first 30 patients were classified as the control group, and the other 30 patients were classified as the experimental group. The control group was given routine nursing care, while the experimental group was given narrative nursing care, and the changes of adverse emotions between the two groups were compared. Results The nursing satisfaction of the experimental group was higher than that of the control group (P < 0.05). Before nursing, there was no difference between the two groups (P > 0.05). After nursing, both groups improved, and the effect of the experimental group was better (P < 0.05). Before nursing, there was no difference in the scores of anxiety and depression between the two groups (P > 0.05). After nursing, both groups improved, and the effect of the experimental group was better (P < 0.05). Conclusion Narrative nursing can effectively alleviate the anxiety and shame of breast cancer patients, which is worth applying.     

乳腺癌术后上肢水肿研究进展

Lymphedema of affected arm is a severe complication after surgery of breast cancer.Quality of life and rehabilitation of patients suffered from breast cancer receive more and more attention with increase of incidence and decrease of mortality,longation of survival time.Lymphedema of arm not only affects esthetics but produce pain,dysfunction,deprivation of work ability,and serious psychological issues.In the current paper,we reviewed progress in study on risk factors associated with surgery,evaluation,prevention and management of lymphedema in arm.     

人性化管理在妇产科手术室护理管理中的应用观察研究

Objective To discuss the value of humanized management application in obstetrics and gynecology operating room nursing management. Methods 200 cases of patients admitted to the department of obstetrics and Gynecology of our hospital in the operating room as the research objective, divided into observation group, reference group by parity method, humanized management application in the observation group, routine operating room nursing management application in the reference group, compare the nursing data of the two groups. Results The rate of nurse-patient dispute in the operation room of the observation group was lower than that of the reference group, and the total incidence of complications was also lower than that of the reference group, which was significant (P＜0.05). Compared with the reference group, all nursing quality scores in the observation group were significantly higher (P＜0.05). The total nursing satisfaction in the observation group was significantly higher than that in the reference group (P＜0.05). Conclusion The application of humanized management in obstetrics and gynecology operating room nursing management, help to improve patient nursing satisfaction, and reduce the incidence of complications, reduce the incidence of nurse-patient disputes, improve the quality of nursing, improve the quality of life of patients, has clinical application value.     

Perioperative nursing principles guided by the concept of enhanced recovery after surgery

Objective:To explore the clinical effect of perioperative nursing guided by the concept of enhanced recovery after surgery and summarize them.Methods:Pubmed,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),Wanfang Database,and VIP Database were searched to obtain the relevant literature involving enhanced recovery after surgery(ERAS)guidance,obtain the effective clinical data,review the reports in literature,and obtain the effective scheme.Results:Compared with the traditional nursing program,perioperative nursing principles guided by the concept of ERAS provide more accurate nursing care to patients and reduce the occurrence of intraoperative stress events through comprehensive nursing measures such as preoperative pre-rehabilitation measures,intraoperative body temperature and fluid management,postoperative analgesia,prevention of nausea and vomiting,early mobilization,catheter nursing,and better out-of-hospital follow-up.Conclusions:Perioperative nursing principles guided by the concept of ERAS can significantly reduce the incidence of perioperative complications,shorten the hospital stay of patients,and promote postoperative rehabilitation of patients.The transformation and implementation of this concept can bring significant benefits to hospitals,medical care,and patients.     

岛状背阔肌肌皮瓣乳房再造加腋前皱襞重建术的护理配合

Objective To study nursing cooperation of second-stage reconstruction of breast and anterior axillary fold with island latissimus dorsi musculocutaneous flap after Radical Mastectomy. Methods Thirteen patients with severe defect of thoracic wall underwent second-stage reconstruction of breast and anterior axillary fold with island latissimus dorsi musculocutaneous flap and breast implants 1 ～ 4 years after the Radical Mastectomy for breast cancer. The nursing cooperation including preoperative preparation of staffs, surgical instruments, and articles, and methods of intraoperative nursing cooperation were retrospectively analyzed.Results Procedure success was gained in all 13 cases, without operation beingg delayed because of surgicalinstruments or poor cooperation. Flaps survived intraoperatively and postoperatively. Primary healing of incision without any infection was observed for all patients. Satisfactory mammary contour was achieved for all patients uneventfully with absence of any complications. Conclusions Careful preoperative preparation of articles and psychological nursing to gain best cooperation of the patients, and skilled intraoperative nursing cooperation are essential for procedure success.     

血清CA153、CA125和CEA联合检测在乳腺癌诊断中的应用

Objective To study the clinical singificance of serum tumor markers (CA153, CA125 and CEA) in doagnosis of breast cancer. Methods Electrochemiluminescence immunoassay (ECLIA) was used to analyze serum levels of CA153,CA125 and CEA in 55 patients with breast canc-er (breast cancer group),20 patients with benign breast lesions (benign breast lesion group) and 20 healthy controls (healthy control group). Results The levels of CA153, CA125 and CEA in breast cancer group were significantly higher than those in healthy control group (P<0.05); the levels of CEA and CA153 in breast cancer group were significantly higher than those in benign breast lesion group (P<0.05);the level of CA153 in postoperative patients was statistically lower than that in pre-operative patients (P<0.05);the levels of CEA and CA153 in breast cancer patients with stage Ⅲ and Ⅳ were significantly higher than those in healthy controls (P<0.05); the level of CA153 with stage Ⅲ and Ⅳ was higher than that in ones with stage Ⅰ and Ⅱ. The combined dection of CA153, CA125 and CEA in breast cancer patients increased the experimental sensitivity to 53.8% and specific-ity to 83.3%. Conclusion Detections of CA153,CA125 and CEA contribute to diagnosis of breast cancer. CA153 and CEA are of clinical practical value in differential diagnosis of benign and malignant breast tumor,monitoring of course of breast cancer.     

岛状背阔肌肌皮瓣乳房再造加腋前皱襞重建术的护理配合

Objective To study nursing cooperation of second-stage reconstruction of breast and anterior axillary fold with island latissimus dorsi musculocutaneous flap after Radical Mastectomy. Methods Thirteen patients with severe defect of thoracic wall underwent second-stage reconstruction of breast and anterior axillary fold with island latissimus dorsi musculocutaneous flap and breast implants 1 ～ 4 years after the Radical Mastectomy for breast cancer. The nursing cooperation including preoperative preparation of staffs, surgical instruments, and articles, and methods of intraoperative nursing cooperation were retrospectively analyzed.Results Procedure success was gained in all 13 cases, without operation beingg delayed because of surgicalinstruments or poor cooperation. Flaps survived intraoperatively and postoperatively. Primary healing of incision without any infection was observed for all patients. Satisfactory mammary contour was achieved for all patients uneventfully with absence of any complications. Conclusions Careful preoperative preparation of articles and psychological nursing to gain best cooperation of the patients, and skilled intraoperative nursing cooperation are essential for procedure success.     

PICC在乳腺癌患者化疗中的应用及护理

目的探讨乳腺癌术后化疗患者行经外周插管的中心静脉导管（peripherally inserted central catheter,PICC）置管后并发症的发生情况．并总结并发症的预防和护理措施。方法采用方便取样法,选择2004年12月-2007年12月乳腺癌术后经PICC置管进行化学治疗的218例患者,置管后给予及时有效的护理。结果218例患者一次穿刺成功率贵要静脉组最高,为97．5％,而正中静脉组和头静脉组分别为89．3％和72．7％。置管后总并发症发生率为25．7％,其中一般并发症20．6％,较重并发症5．1％,元严重并发症发生,化疗过程均顺利。结论乳腺癌术后对需化疗的患者行PICC置管,可以更好地保护血管以及周围组织,减少静脉炎及避免化疗药物渗漏引起的严重并发症,而正确有效的护理是PICC留置成功的关键。     

风险防范管理体系在乳腺癌静脉输液港置管化疗患者中的应用

目的探讨风险防范管理体系对降低乳腺癌化疗患者输液港置管不良事件发生率、提高护理满意度的效果。方法选择医院乳腺癌初次放置静脉输液港化疗的患者为研究对象,其中2019年4—6月收治的48例为对照组,给予常规护理;2020年1—4月收治的49例患者为观察组,在对照组基础上实施风险防范管理体系护理,比较两组患者置管后6个月植入式静脉输液港不良事件发生情况及护理满意度。结果观察组患者静脉输液港不良事件发生率低于对照组(P<0.05),护理满意度高于对照组(P<0.05)。结论风险防范管理体系应用于乳腺癌输液港置管化疗患者能降低不良事件发生率,提高患者护理满意度。     

改良皮瓣引流护理方案在乳腺癌术后患者中的应用效果

目的 探讨改良皮瓣引流护理方案在乳腺癌术后患者皮下积液中的应用效果。 方法选取我院2016年1月-2018年1月收治的术后发生皮下积液的乳腺癌患者94例,将其随机分成对照组与观察组,每组47例。对照组术后接受常规护理,观察组患者接受改良皮瓣引流护理方案,即采用弹力包扎带加压,应用组合引流方案进行皮瓣引流,并使用制动袖套约束患者动作范围。比较2组患者腋窝及胸部引流量、并发症发生情况、生活质量、炎症因子、疼痛程度。 结果 2组患者腋窝及胸部引流量在时间、组间及交互效应方面比较,差异均具有统计学意义。观察组并发症发生率低于对照组(χ²=11.692,P<0.001),患者生活质量评分显著高于对照组。观察组炎症因子TNF-α和IL-6水平均明显低于对照组(t=11.539,P<0.001; t=57.808,P<0.001);观察组疼痛评分显著低于对照组(t=16.142,P<0.001)。 结论 改良皮瓣引流护理方案能减少乳腺癌患者术后皮下积液、皮瓣坏死、上肢肿胀,提高患者生活质量,减轻疼痛,值得推荐使用。     

提升化疗药物外渗安全管理质量的实践与效果

目的 提升化疗药物外渗安全管理质量.方法 成立由专科护理管理委员会、肿瘤专科护理小组、临床护士组成的预防化疗药物外渗安全管理三级监控网,修订并完善了安全管理措施,实行个案追踪护理,促进了管理质量的持续改进.结果 规范了化疗专业护理行为,降低了化疗药物外渗发生率,医疗护理纠纷的发生率为零.结论 实施化疗药物外渗安全管理,为患者提供安全、有效的护理措施,可降低化疗药物外渗发生率,避免医疗护理纠纷的发生.     

改良乳腺癌根治术后皮瓣坏死的预防

目的 探讨如何降低改良乳腺癌根治术后皮瓣坏死的发生率.方法 80例采用改良乳腺癌根治术患者被分为两组.2004年1月至2007年1月48例作为对照组(改良乳腺癌根治术切口采用Stewart切口或纵切口,且术后不使用丹参和医用伤口护理膜);2007年1月至2010年1月32例作为研究组(手术切口采用改良Stewart切口,在改良乳腺癌根治术后使用丹参和医用伤口护理膜).对两组间术后皮瓣坏死情况进行对比研究.结果 对照组术后皮瓣坏死率是31.25℅,而研究组是9.37℅,两组间有显著差异﹙P﹤0.05﹚.结论 采用Z形切口设计,合理的皮瓣厚度,避免皮瓣张力,防止淋巴管漏,有效的双管引流,合理包扎及丹参、医用伤口护理膜的使用均是预防改良乳腺癌根治术后皮瓣坏死的关键.     

品管圈在乳腺癌根治切除术中的护理效果及对患者并发症发生情况的影响

目的探讨品管圈在乳腺癌根治切除术中的护理效果及对患者并发症发生情况的影响。方法选择2017年1月至2018年12月的180例乳腺癌患者作为研究对象,根据纳入患者的时间点将其分为对照组(90例,2017年1月至2017年12月)和观察组(90例,2018年1月至2018年12月)。两组均给予乳腺癌根治切除术,对照组给予常规方法管理,观察组采用品管圈管理。比较两组患者的并发症发生情况和观察组圈员品管圈活动前、后的无形成果。结果观察组的疲劳、恶心呕吐、上肢水肿、皮瓣坏死、积液、出血的发生率均低于对照组(P<0.05)。品管圈活动后,观察组全体圈员发现并解决问题的能力、凝聚力、自信心、学习新事物的能力、拓展思维能力、合作能力及沟通能力均优于活动前。结论品管圈护理方案用于乳腺癌手术治疗中能降低患者的并发症发生率,值得临床推广应用。     

化疗管理表在乳腺癌个案管理中的应用效果研究

目的探讨化疗管理表在乳腺癌个案管理模式中的应用效果。方法采用便利抽样法,选取中山大学肿瘤防治中心2016年1月—2017年12月进入乳腺癌个案管理的乳腺癌患者为研究对象。将2016年1—12月收入的182例患者纳入对照组;将2017年1—12月收入的183例患者纳入干预组。对照组开展乳腺癌个案管理模式,干预组在此基础上应用化疗管理方案表对患者进行护理。比较两组干预效果。结果对照组按时完成化疗患者占98.35%(179/182),干预组为99.45%(182/183),两组化疗依从性比较差异无统计学意义(χ^2=0.258,P>0.05);对照组患者辅助检查按时完成率84.06%(153/182),干预组为98.36%(180/183),两组化疗辅助检查按时完成率比较差异有统计学意义(χ^2=21.559,P<0.01);对照组患者处理异常指标准确率为75.82%(138/182),干预组为92.90%(170/183),两组患者处理化疗辅助检查异常指标准确率比较差异有统计学意义(χ^2=20.182,P<0.01)。干预组患者主动向个案管理师汇报身体状况和检查结果共1020例次,对照组为210例次。结论乳腺癌个案管理模式应用化疗管理表能提高乳腺癌患者术后化疗辅助检查的依从性,提高处理异常检查指标的能力,提高患者主动咨询的积极性和个案管理师的工作效率。     

乳腺癌术后中心静脉置管患者围化疗期预防静脉血栓临床护理路径的构建及研究进展

目的 针对乳腺癌术后化疗患者静脉血栓的发生与治疗，构建个性化与规范化相结合的临床护理路径，并将此路径运用于临床 方法 在文献回顾的同时对我院乳腺外科及血管科医护人员进行质性访谈，使用Caprini量表、随访记录单的同时，增加采用Khorana量表及对D-二聚体数值的监控，以此为依据构建临床护理路径。将上海市第一人民医院南院治的360例乳腺癌术后化疗患者按照入院时间分为观察组和对照组各180例，分别实施临床护理路径护理模式和常规护理模式。 结果 使用临床护理路径对患者进行早期监测与干预可有效降低乳腺癌围化疗期静脉血栓发生率（P<0.01），患者置管手臂红肿疼痛，血管B超确诊血栓后药物治疗、停用中心静脉装置情况均有所减少（P<0.05），患者满意度有所提高（P<0.05）。结论 对乳腺癌术后化疗患者实施临床护理路径能有效预防患者静脉血栓的发生，提高护理质量。     

人文关怀对乳腺癌术后化疗患者不良反应及生存质量的影响

目的：探讨人文关怀对乳腺癌术后化疗患者不良反应及生存质量的影响。方法选取2010年1月-2012年12月收治的乳腺癌术后化疗患者96例,按照随机数字表法随机分为对照组和观察组各48例,对照组给予常规护理,观察组在对照组基础上给予健康教育和心理护理等细致人文关怀的护理干预,分析两种护理方法对患者术后化疗不良反应及生存质量的影响。结果观察组患者术后化疗引起的不良反应总评分为（29．98±13．12）分,对照组为（41．53±14．37）分,两组比较差异有统计学意义（t＝4．32,P ＜0．01）。观察组患者生活质量总评分为（64．81±15．36）分,对照组为（48．91±15．07）分,两组比较差异有统计学意义（t＝5．35,P＜0．01）。结论健康教育和心理护理等细致人文关怀能够有效提高乳腺癌术后化疗患者的生存质量,减少术后化疗引起的不良反应。