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综合护理干预在非肌层浸润性膀胱移行细胞癌患者中的应用
引用本文:董春琴,傅文珍,傅亚飞,翁东.综合护理干预在非肌层浸润性膀胱移行细胞癌患者中的应用[J].中华现代护理杂志,2014(18):2225-2228.
作者姓名:董春琴  傅文珍  傅亚飞  翁东
作者单位:浙江省绍兴市人民医院浙江大学绍兴医院泌尿外科,312000
摘    要:目的:探讨综合护理干预在非肌层浸润性膀胱移行细胞癌患者术后的应用效果,为患者的术后治疗和康复提供有效的护理措施。方法将109例非肌层浸润性膀胱移行细胞癌患者随机分为观察组59例和对照组50例。对照组采用术后一般护理、膀胱冲洗护理、膀胱灌注化疗护理、术后并发症知识宣教等护理措施;观察组在此基础上给予综合护理干预措施。观察两组的治疗效果和术后不良反应的发生情况。采用SF-36健康调查得表( SF-36)评估患者术后生活质量,采用焦虑自评量表( SAS )、抑郁自评量表( SDS)评价患者心理状态,采用自制调查表调查护理满意度。结果两组患者手术均成功,术后随访时间(26.1±7.8)个月。观察组术后复发率20.3%(12/59);对照组术后复发率18.0%(9/50),两组患者术后复发率差异无统计学意义(χ2=1.237,P>0.05)。观察组术后不良反应发生率为25.4%(15/59),对照组为30.0%(15/50),两组比较差异无统计学意义(χ2=2.301,P>0.05)。护理干预后观察组的SF-36量表生活质量总分为(596.1+113.4)分,高于对照组(512.4+109.9)分,差异有统计学意义(t=7.926,P<0.05);SF-36量表中TH、RP、MH、VT、RE、SF6项的评分结果均高于对照组,差异有统计学意义(t值分别为4.596,5.028,5.137,5.918,7.009,6.402;P<0.05);护理干预后两组的SDS、SAS量表评分结果均低于本组护理前,差异有统计学意义(t=5.891,4.013;P<0.05);护理后观察组的SDS、SAS量表评分均低于对照组,差异有统计学意义(t=3.815,4.202;P<0.05)。观察组的护理满意度为93.2%(55/59),高于对照组72.0%(36/50),差异有统计学意义(U=4.716,P<0.05)。结论采用综合护理措施可有效提高非肌层浸润性膀胱移

关 键 词:非肌层浸润性膀胱移行细胞癌  生活质量  综合护理干预  护理满意度

Application of comprehensive nursing intervention in patients with non-muscle invasive bladder transitional cell carcinoma
Dong Chunqin,Fu Wenzhen,Fu Yafei,Weng Dong.Application of comprehensive nursing intervention in patients with non-muscle invasive bladder transitional cell carcinoma[J].Chinese Journal of Modern Nursing,2014(18):2225-2228.
Authors:Dong Chunqin  Fu Wenzhen  Fu Yafei  Weng Dong
Institution:(Department of Urinary Surgery, Shaoxing People' s Hospital of Zhejiang Province, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, China)
Abstract:Objective To find out the efficacy of postoperative care of patients with non-muscle invasive bladder transitional cell carcinoma and to provide effective interventions for the treatment and rehabilitation of patients after surgery .Methods 109 patients with non-muscle invasive bladder transitional cell carcinoma were randomly divided into the observation group (59 cases) and the control group (50 cases).The control group was cared with the measures included postoperative general nursing intervention , bladder irrigation, intravesical chemotherapy , postoperative complication nursing .Based on these nursing interventions , the observation group was treated with integrated care measures .Patients’ quality of life, mental state and depression were assessed by the Short Form 36 ( SF-36 ) , Self-rating Anxiety Scale ( SAS ) and Self-rating Depression Scale ( SDS), respectively.Nursing satisfaction was investigated by self-made questionnaire. Results Two groups of patients were successfully operated .The postoperative follow-up period was ( 26 .1 ±7.8) months.Recurrence rate of the observation group and the control group were 20.3%(12/59) and 18.0%(9/50), respectively, showed no significant difference (χ2 =1.237,P〉0.05).Postoperative incidence of adverse events of observation group and the control group were 25.4% (15/59) and 30.0% (15/50), respectively, showed no significant difference (χ2 =2.301,P〉0.05).The SF-36 scores of TH, RP, MH, VT, RE, SF for the observation group were significantly higher ( t =4.596,5.028,5.137,5.918,7.009, 6.402, respectively;P〈0.05) than those in the control group .After integrated care measures , the SDS and SAS scores of both groups were significantly lower than before (t=5.891,4.013, respectively;P〈0.05).And the SDS and SAS scores in the observation group were significantly lower than those in the control group ( t=3.815,4.202, respectively;P〈0.05).Satisfaction with nursing for the observation group was 93.2%(5
Keywords:Non-muscle invasive bladder cancer  Comprehensive nursing intervention  Quality of life  Nursing satisfaction
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