舒适护理对乳腺癌改良根治术患者围术期的心理状况(1)
[摘要] 目的 探讨舒适护理对乳腺癌改良根治术患者围术期心理状况及疼痛的影响。 方法 选择2013年5月～2015年4月我院行乳腺癌改良根治术患者100例，全部患者分为研究组和对照组各50例，对照组患者实施常规护理，研究组患者实施舒适护理，比较两组患者术前和术后SAS评分、SDS评分的变化及两组患者术后疼痛缓解率。 结果 术后两组患者 SAS、SDS评分均显著低于术前(P<0.05)，且研究组乳腺癌改良根治术患者SAS、SDS 评分分别较对照组降低更显著(P<0.05)。研究组患者术后疼痛缓解率达94%(47/50)，显著高于对照组的 84%(42/50)(P<0.05)。 结论 适护护理能够显著缓解乳腺癌改良根治术患者围术期的心理负担和减轻患者的疼痛，值得在今后临床护理工作中积极推广应用。
[关键词] 围术期；舒适护理；乳腺癌改良根治术；音乐疗法；心理状况；疼痛；数字疼痛分级(NRS)护理
[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701(2016)10-0156-04
[Abstract] Objective To discuss the effect of comfortable nursing on psychologic status and pain in patients at perioperative period of modified radical mastectomy. Methods A total of 100 patients who were given modified radical mastectomy in our hospital from May 2013 to April 2015 were selected and equally divided into the study group and the control group. Patients in the control group were given routine nursing， while patients in the study group were given comfortable nursing. The changes of SAS score and SDS score before and after operation and remission rate of pain after operation were compared between two groups. Results The SAS score and SDS score in both groups after operation were significantly lower than those before operation(P<0.05)， and the reduction of SAS score and SDS score in the study group was more significant than that in the control group(P<0.05). The remission rate of pain after operation was 94%(47/50) in the study group， which was significantly higher than that in the control group(84%， 42/50) (P<0.05). Conclusion Comfortable nursing can significantly relieve the psychological burden and physiological pain of patients at perioperative period of modified radical mastectomy， which is worthy to be promoted.
[Key words] Perioperative period； Comfortable nursing； Modified radical mastectomy； Musicotherapy； Psychologic status； Pain； NRS nursing
乳腺癌是指发生在乳腺腺上皮组织的恶性肿瘤，一旦癌细胞脱落，游离的癌细胞可以随着血液循环扩散至其他部位，危及患者生命安全。因而，乳腺癌已经成为了目前重大公共卫生疾病[1，2]。随着乳腺癌综合治疗的相继实施，该病症死亡率已得到有效控制，但是术后患者心理状况不佳及剧烈疼痛成为临床重点关注的问题。舒适护理是以患者为中心，以患者的最佳舒适感和满意度为护理目标，使患者在生理、心理上达到最愉快状态的一种护理模式，为确保手术的顺利进行创造了良好的条件[3]。为此，本研究针对围术期舒适护理在乳腺癌改良根治术患者心理状况及疼痛中的干预效果展开深入研究，现报道如下。
1 资料与方法
1.1 一般资料
选取我院2013年5月～2015年4月收治的100例行乳腺癌改良根治术治疗的乳腺癌患者为研究对象，所有患者均为女性，年龄28～55岁，平均(41.5±2.0)岁，病程时间3个月～5年，临床表现：乳头肿块、乳头溢液、皮肤橘皮样改变、乳头(晕)异常、腋窝淋巴结肿，发癌部位：左侧48例，右侧43例，两侧9例。纳入标准：①经临床诊断确诊为乳腺癌者；②所有患者均行乳腺癌改良根治术治疗；③无其他严重合并症者，如心力衰竭、糖尿病、神经功能障碍等；④临床依从性好者。排除标准：①乳腺癌合并肝肾功能衰竭者；②临床依从性差者；③不同意本次研究方案者。本文采用随机数字表法进行分组，分为对照组及研究组各50例，两组患者在性别、病程时间、发癌部位、临床表现等一般资料方面差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(赵素凡 陈海燕)
[关键词] 围术期；舒适护理；乳腺癌改良根治术；音乐疗法；心理状况；疼痛；数字疼痛分级(NRS)护理
[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701(2016)10-0156-04
[Abstract] Objective To discuss the effect of comfortable nursing on psychologic status and pain in patients at perioperative period of modified radical mastectomy. Methods A total of 100 patients who were given modified radical mastectomy in our hospital from May 2013 to April 2015 were selected and equally divided into the study group and the control group. Patients in the control group were given routine nursing， while patients in the study group were given comfortable nursing. The changes of SAS score and SDS score before and after operation and remission rate of pain after operation were compared between two groups. Results The SAS score and SDS score in both groups after operation were significantly lower than those before operation(P<0.05)， and the reduction of SAS score and SDS score in the study group was more significant than that in the control group(P<0.05). The remission rate of pain after operation was 94%(47/50) in the study group， which was significantly higher than that in the control group(84%， 42/50) (P<0.05). Conclusion Comfortable nursing can significantly relieve the psychological burden and physiological pain of patients at perioperative period of modified radical mastectomy， which is worthy to be promoted.
[Key words] Perioperative period； Comfortable nursing； Modified radical mastectomy； Musicotherapy； Psychologic status； Pain； NRS nursing
乳腺癌是指发生在乳腺腺上皮组织的恶性肿瘤，一旦癌细胞脱落，游离的癌细胞可以随着血液循环扩散至其他部位，危及患者生命安全。因而，乳腺癌已经成为了目前重大公共卫生疾病[1，2]。随着乳腺癌综合治疗的相继实施，该病症死亡率已得到有效控制，但是术后患者心理状况不佳及剧烈疼痛成为临床重点关注的问题。舒适护理是以患者为中心，以患者的最佳舒适感和满意度为护理目标，使患者在生理、心理上达到最愉快状态的一种护理模式，为确保手术的顺利进行创造了良好的条件[3]。为此，本研究针对围术期舒适护理在乳腺癌改良根治术患者心理状况及疼痛中的干预效果展开深入研究，现报道如下。
1 资料与方法
1.1 一般资料
选取我院2013年5月～2015年4月收治的100例行乳腺癌改良根治术治疗的乳腺癌患者为研究对象，所有患者均为女性，年龄28～55岁，平均(41.5±2.0)岁，病程时间3个月～5年，临床表现：乳头肿块、乳头溢液、皮肤橘皮样改变、乳头(晕)异常、腋窝淋巴结肿，发癌部位：左侧48例，右侧43例，两侧9例。纳入标准：①经临床诊断确诊为乳腺癌者；②所有患者均行乳腺癌改良根治术治疗；③无其他严重合并症者，如心力衰竭、糖尿病、神经功能障碍等；④临床依从性好者。排除标准：①乳腺癌合并肝肾功能衰竭者；②临床依从性差者；③不同意本次研究方案者。本文采用随机数字表法进行分组，分为对照组及研究组各50例，两组患者在性别、病程时间、发癌部位、临床表现等一般资料方面差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(赵素凡 陈海燕)