经气管镜超声引导针吸活检术诊断肺癌的配合及护理研究

目的探讨实时超声支气管镜引导下的经支气管针吸活检术（EBUS—TBNA）诊断肺癌的配合及护理干预措施。方法回顾分析解放军总医院2010年11月～2012年5月60例经胸部CT或PET—CT检查显示为纵膈和（或）肺门淋巴结肿大和（或）胸内气管旁肿块（≥1cm）患者行EBUS—TBNA的资料。将患者分为两组，每组各30例，对照组给予常规护理，观察组在对照组基础上给予术中配合及心理护理，并对两组患者的呼吸困难程度和情绪反应进行测量，比较并发症的发生率。结果护理干预对呼吸网难症状及情绪反应的影响：观察组患者的焦虑、抑郁程度明显低于对照组[观察组：（8．14±1．33）、（4．96±1．78）分]，对照组：（16．22±5．30）、（14．28±4．20）分]VAS评分明显高于对照组[观察组：（58．62±9．57）分，对照组：（11．24±3．47）分1（P〈0．05）；观察组并发症发生率为6．67％，对照组并发症发生率为33．33％，两组比较差异有高度统计学意义（P〈0．01）。结论做好超声支气管镜引导下的经支气管针吸活检术的护理配合，对提高肺癌诊断率，避免并发症具有重大意义。

Cooperation and nursing study of endobronchial ultrasound guided transbronchial needle aspiration in diagnosis of lung cancer

Objective To investigate the cooperation of real time endobronchial ultrasound guided transbronchial needle aspiration （EBUS-TBNA） in diagnosis of lung cancer and its nursing intervention measure. Methods The EBUSTBN data of 60 patients with chest CT or PET-CT examination showed mediastinal and （or） hilus pulmonis lymph node enlargement and （or） intrathoracic paratracheal masses （≥ 1 cm ） in the general hospital of PLA were analyzed retrospectively from November 2010 to May 2012. All patients were divided into two groups, each group had 30 cases. Patients in the control group were implemented routine nursing care, then patients in the observation group were given intraoperative coordination and mental nursing on basis of the control group. The degree of difficulty in breathing and emotional reaction of patients in the two groups were measured, and the incidence of complications was compared. Results The effects of nursing intervention on emotional reaction and difficulty in breathing： the degrees of anxiety, depression in the observation group were significantly lower than those of the control group ]observation group： （8.14± 1.33）, （4.96±1.78） scores; control group： （16.22±5.30）, （14.28±4.20） scores], VAS score was significantly higher than that of the control group [obervation group： （58.62±9.57） scores, control group： （11.24±3.47） scores] （P 〈 0.05）; the complication rate in the observation group was 6.67%, which in the control group was 33.33%, there was significant difference between two groups （P 〈 0.01）. Conclusion Doing well nursing coordination in EBUS-TBNA can improve the diagnosis rate of lung cancer, and has great significance for avoiding the incidence of complication.