优质护理在腹腔镜子宫肌瘤剔除术患者术后护理效果研究
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摘要
为探讨优质护理在腹腔镜子宫肌瘤剔除术患者术后护理中的应用价值。本研究选取接受腹腔镜子宫肌瘤剔除术治疗的140例患者作为研究对象,采用随机数字表分为优质组(优质护理模式)、常规组(常规护理模式)各70例,比较两组患者干预前后的生存质量(GQOL-74评分)、简明心境状态测试(pOMS)量表评分的变化。结果显示,干预前,优质组和常规组患者的角色功能、躯体功能、心理功能、社会功能、GQOL-74量表总体评分差异无统计学意义(p>0.05);干预后,优质组患者的角色功能、躯体功能、心理功能、社会功能、GQOL-74量表总体评分均显著高于常规组(p<0.05);干预前,优质组和常规组患者的抑郁、疲劳、紧张、愤怒、慌乱、精力、与自我有关的情绪评分差异无统计学意义(p>0.05);干预后,优质组患者的精力、与自我有关的情绪评分均显著高于常规组(p<0.05),优质组患者的抑郁、疲劳、紧张、愤怒、慌乱评分均显著低于常规组(p<0.05)。本研究表明优质护理在腹腔镜子宫肌瘤剔除术患者术后护理中能有效改善患者的生存质量及不良心境情绪。
To explore the value of high quality nursing in postoperative care of patients undergoing laparoscopic myomectomy, in this study, 140 patients who underwent laparoscopic myomectomy were selected as subjects.They were divided into high-quality group(quality nursing mode) and routine group(conventional nursing mode)by random digital table, 70 patients in each group. We compared the changes in quality of life(GQOL-74 score) and Brief Profile of Mood States(pOMS) scale of the patients between two groups before and after the intervention.The results showed that there was no statistical significance in the role function, physical function, psychological function, social function, and overall GQOL-74 score of patients between the high quality group and the routine group before intervention(p>0.05). After the intervention, those of the patients in the high quality group were significantly higher than the routine group(p<0.05). After the intervention, there was no statistical significance in high-quality group and routine group of patients with depression, fatigue, nervousness, anger, confusion, energy and self-related emotional scores(p>0.05). After the intervention, the energy and self-related emotional scores of the high quality group were significantly higher than those of the routine group(p<0.05). The depression, fatigue,stress, anger, and fluster scores of the high quality group were significantly lower than the routine group(p<0.05).This study demonstrated that high quality nursing could effectively improve patients' quality of life and bad mood in postoperative care of laparoscopic myomectomy.
To explore the value of high quality nursing in postoperative care of patients undergoing laparoscopic myomectomy, in this study, 140 patients who underwent laparoscopic myomectomy were selected as subjects.They were divided into high-quality group(quality nursing mode) and routine group(conventional nursing mode)by random digital table, 70 patients in each group. We compared the changes in quality of life(GQOL-74 score) and Brief Profile of Mood States(pOMS) scale of the patients between two groups before and after the intervention.The results showed that there was no statistical significance in the role function, physical function, psychological function, social function, and overall GQOL-74 score of patients between the high quality group and the routine group before intervention(p>0.05). After the intervention, those of the patients in the high quality group were significantly higher than the routine group(p<0.05). After the intervention, there was no statistical significance in high-quality group and routine group of patients with depression, fatigue, nervousness, anger, confusion, energy and self-related emotional scores(p>0.05). After the intervention, the energy and self-related emotional scores of the high quality group were significantly higher than those of the routine group(p<0.05). The depression, fatigue,stress, anger, and fluster scores of the high quality group were significantly lower than the routine group(p<0.05).This study demonstrated that high quality nursing could effectively improve patients' quality of life and bad mood in postoperative care of laparoscopic myomectomy.
引文
Baird D.D.,Dunson D.B.,Hill M.C.,Cousins D.,and Schectman J.M.,2003,High cumulative incidence of uterine leiomyoma in black and white women:ultrasound evidence,Am.J.Obstet.Gynecol.,188(1):100-107
Bulun S.E.,2013,Uterine fibroids,New England Journal of Medicine,369(14):1344-1355
Ciavattini A.,Di J.G.,Stortoni P.,Montik N.,Giannubilo S.R.,Litta P.,Islam M.S.,Tranquilli A.L.,Reis F.M.,and Ciarmela P.,2013,Uterine fibroids:pathogenesis and interactions with endometrium and endomyometrial junction,Obstetrics and Gynecology International,(4):173184
Deng X.F.,2015,Observation on the perioperative period nursing for patients received laparoscopic myomectomy,Qiqihaer Yixueyuan Xuebao(Journal of Qiqihar University of Medicine),7(19):2957-2958(邓小凤,2015,腹腔镜子宫肌瘤切除患者围手术期的护理观察,齐齐哈尔医学院学报,7(19):2957-2958)
Du J.,2016,Clinical nursing of patients with benign uterine fibroids treated by minimally invasive laparoscopic surgery,Shiyong Linchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),20(12):108-110(杜鹃,2016,良性子宫肌瘤患者行腹腔镜下微创手术的临床护理,实用临床医药杂志,20(12):108-110)
Flake G.P.,Andersen J.,and Dixon D.,2003,Etiology and pathogenesis of uterine leiomyomas:a review,Environmental Health Perspectives,111(8):1037-1054
Gao Z.Z.,2007,Analysis of effect of mifepristone on treatment of48 women with uterine leiomyomas in permenopausal,Zhongyao Yu Linchuang(Pharmacy and Clinics of Chinese Materia Medica),26(1):23-24(高中泽,2007,米非司酮治疗48例围绝经期子宫肌瘤结果分析,中药与临床,26(1):23-24)
Greathouse K.L.,Bredfeldt T.,Everitt J.I.,Lin K.,Berry T.,Kannan K.,Mittelstadt M.L.,Ho S.M.,and Walker C.L.,2012,Environmental estrogens differentially engage the histone methyltransferase ezh2 to increase risk of uterine tumorigenesis,Molecular Cancer Research,10(4):546-557
Guo X.M.,2017,Effects of innovative nursing practice based on the idea of homogeneous medical treatment on stress reaction in patients with laparoscopic myomectomy during the perioperative period,Zhonghua Xiandai Huli Zazhi(Chinese Journal of Modern Nursing),23(32):4148-4151(郭晓敏,2017,同质医疗理念创新型护理实践对腹腔镜子宫肌瘤切除患者围术期应激反应的影响,中华现代护理杂志,23(32):4148-4151)
Hurst B.S.,Matthews M.L.,and Marshburn P.B.,2005,Laparoscopic myomectomy for symptomatic uterine myomas,Fertility&Sterility,83(1):1-23
Leone R.M.U.,Scala C.,Venturini P.L.,and Ferrero S.,2014,Preoperative treatment with letrozole in patients undergoing laparoscopic myomectomy of large uterine myomas:a prospective non-randomized study,Eur.J.Obstet.Gynecol.Reprod.Biol.,18(1C):157-162
Li X.H.,Meng W.,and Gui S.Q.,2007,Research of gene expression associated with the genesis of uterine leiomyoma,Shengzhi Yu Biyun(Reproduction and Contraception),27(4):270-276(李小花,孟炜,归绥琪,2007,子宫肌瘤发病相关基因表达研究,生殖与避孕,27(4):270-276)
Liu X.L.,and Du R.,2016,Effect of high quality nursing on improvement of the disease awareness and treatment compliance in patients with transient ischemic attack,Shiyong Liinchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),(8):14-16(刘晓玲,杜蓉,2016,优质护理改善短暂性脑缺血发作患者疾病认知度与依从性的效果,实用临床医药杂志,(8):14-16)
Morelli M.,La Ferrera N.,Gallo F.,Venturella R.,Di Cello A.,Russo V.,De Trana E.,Albano A.,and Zullo F.,2014,Use of progesterone releasing intrauterine system in menhorragia relapse prevention after laparoscopic myomectomy,Minerva Ginecol.,25(66):461-467
Tommaso S.D.,Massari S.,Malvasi A.,Bozzetti M.P.,and Tinelli A.,2013,Gene expression analysis reveals an angiogenic profile in uterine leiomyoma pseudocapsule,Molecular Human Reproduction,19(6):380-387
Walker C.L.,2011,Epigenomic reprogramming of the developing reproductive tract and disease susceptibility in adult hood,Birth Defects Res.A Clin.Mol.Teratol.,91(8):666-671
Wallach E.E.,and Vlahos N.F.,2004,Uterine myomas:an overview of development,clinical features,and management,Obstet.Gynecol.,104(2):393-406
Wang L.,Mou X.,Xiao L.,and Tang L.,2013,T-cadherin expression in uterine leiomyoma,Arch.Gynecol.Obstet.,288(3):607-614
Yuan H.,Zhao S.J.,Gong H.,Liang X.,and Wang Q.F.,2015,Effects of three surgical modalities on ovarian reserve by assessing the serum level of anti-Mullerian hormone for uterine fibroids,Zhonghua Quanke Yishi Zazhi(Chinese Journal of General Practitioners),14(5):377-380(袁华,赵绍杰,龚华,梁喜,王沂峰,2015,腹腔镜下次全子宫与全子宫切除、肌瘤剔除术对子宫肌瘤患者卵巢储备功能的影响,中华全科医师杂志,14(5):377-380)
Zhang X.M.,Wang L.Y.,Lu H.X.,Li J.,and Kong J.Y.,2015,The effect of perioperative nursing in patients with laparoscopic resection of uterine fibroids,Zhongguo Weisheng Biaozhun Guanli(China Health Standard Management),6(21):214-215(张晓梅,王立媛,卢海侠,李婧,孔庆宇,2015,探讨围手术期护理对腹腔镜子宫肌瘤切除患者的干预效果,中国卫生标准管理,6(21):214-215)
Zhao Y.H.,2015,Study on perioperative nursing of patients with uterine fibroids resection,Shiyong Linchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),11(18):81-84(赵云华,2015,子宫肌瘤切除患者的围术期护理研究,实用临床医药杂志,11(18):81-84)
Zheng C.Q.,Ding X.B.,and Wu F.H.,2014,Application of high-quality nursing interventions in reducing incidence of post-laparoscopy infections and complications,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),12(24):160-161(郑超群,丁小波,吴方红,2014,优质护理干预在降低腹腔镜术后感染中的应用,中华医院感染学杂志,12(24):160-161)
Zhi H.,Qin D.H.,Shan C.M.,and Sun J.,2014,Quality care in perioperative cardiovascular surgery applications,Zhongxiyi Jiehe Xinxueguanbing Dianzi Zazhi(Medical Innovation of China),(17):77-79(支慧,秦德华,山慈明,孙静,2014,优质护理服务在心血管外科手术围术期的应用,中西医结合心血管病电子杂志,(17):77-79)
Bulun S.E.,2013,Uterine fibroids,New England Journal of Medicine,369(14):1344-1355
Ciavattini A.,Di J.G.,Stortoni P.,Montik N.,Giannubilo S.R.,Litta P.,Islam M.S.,Tranquilli A.L.,Reis F.M.,and Ciarmela P.,2013,Uterine fibroids:pathogenesis and interactions with endometrium and endomyometrial junction,Obstetrics and Gynecology International,(4):173184
Deng X.F.,2015,Observation on the perioperative period nursing for patients received laparoscopic myomectomy,Qiqihaer Yixueyuan Xuebao(Journal of Qiqihar University of Medicine),7(19):2957-2958(邓小凤,2015,腹腔镜子宫肌瘤切除患者围手术期的护理观察,齐齐哈尔医学院学报,7(19):2957-2958)
Du J.,2016,Clinical nursing of patients with benign uterine fibroids treated by minimally invasive laparoscopic surgery,Shiyong Linchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),20(12):108-110(杜鹃,2016,良性子宫肌瘤患者行腹腔镜下微创手术的临床护理,实用临床医药杂志,20(12):108-110)
Flake G.P.,Andersen J.,and Dixon D.,2003,Etiology and pathogenesis of uterine leiomyomas:a review,Environmental Health Perspectives,111(8):1037-1054
Gao Z.Z.,2007,Analysis of effect of mifepristone on treatment of48 women with uterine leiomyomas in permenopausal,Zhongyao Yu Linchuang(Pharmacy and Clinics of Chinese Materia Medica),26(1):23-24(高中泽,2007,米非司酮治疗48例围绝经期子宫肌瘤结果分析,中药与临床,26(1):23-24)
Greathouse K.L.,Bredfeldt T.,Everitt J.I.,Lin K.,Berry T.,Kannan K.,Mittelstadt M.L.,Ho S.M.,and Walker C.L.,2012,Environmental estrogens differentially engage the histone methyltransferase ezh2 to increase risk of uterine tumorigenesis,Molecular Cancer Research,10(4):546-557
Guo X.M.,2017,Effects of innovative nursing practice based on the idea of homogeneous medical treatment on stress reaction in patients with laparoscopic myomectomy during the perioperative period,Zhonghua Xiandai Huli Zazhi(Chinese Journal of Modern Nursing),23(32):4148-4151(郭晓敏,2017,同质医疗理念创新型护理实践对腹腔镜子宫肌瘤切除患者围术期应激反应的影响,中华现代护理杂志,23(32):4148-4151)
Hurst B.S.,Matthews M.L.,and Marshburn P.B.,2005,Laparoscopic myomectomy for symptomatic uterine myomas,Fertility&Sterility,83(1):1-23
Leone R.M.U.,Scala C.,Venturini P.L.,and Ferrero S.,2014,Preoperative treatment with letrozole in patients undergoing laparoscopic myomectomy of large uterine myomas:a prospective non-randomized study,Eur.J.Obstet.Gynecol.Reprod.Biol.,18(1C):157-162
Li X.H.,Meng W.,and Gui S.Q.,2007,Research of gene expression associated with the genesis of uterine leiomyoma,Shengzhi Yu Biyun(Reproduction and Contraception),27(4):270-276(李小花,孟炜,归绥琪,2007,子宫肌瘤发病相关基因表达研究,生殖与避孕,27(4):270-276)
Liu X.L.,and Du R.,2016,Effect of high quality nursing on improvement of the disease awareness and treatment compliance in patients with transient ischemic attack,Shiyong Liinchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),(8):14-16(刘晓玲,杜蓉,2016,优质护理改善短暂性脑缺血发作患者疾病认知度与依从性的效果,实用临床医药杂志,(8):14-16)
Morelli M.,La Ferrera N.,Gallo F.,Venturella R.,Di Cello A.,Russo V.,De Trana E.,Albano A.,and Zullo F.,2014,Use of progesterone releasing intrauterine system in menhorragia relapse prevention after laparoscopic myomectomy,Minerva Ginecol.,25(66):461-467
Tommaso S.D.,Massari S.,Malvasi A.,Bozzetti M.P.,and Tinelli A.,2013,Gene expression analysis reveals an angiogenic profile in uterine leiomyoma pseudocapsule,Molecular Human Reproduction,19(6):380-387
Walker C.L.,2011,Epigenomic reprogramming of the developing reproductive tract and disease susceptibility in adult hood,Birth Defects Res.A Clin.Mol.Teratol.,91(8):666-671
Wallach E.E.,and Vlahos N.F.,2004,Uterine myomas:an overview of development,clinical features,and management,Obstet.Gynecol.,104(2):393-406
Wang L.,Mou X.,Xiao L.,and Tang L.,2013,T-cadherin expression in uterine leiomyoma,Arch.Gynecol.Obstet.,288(3):607-614
Yuan H.,Zhao S.J.,Gong H.,Liang X.,and Wang Q.F.,2015,Effects of three surgical modalities on ovarian reserve by assessing the serum level of anti-Mullerian hormone for uterine fibroids,Zhonghua Quanke Yishi Zazhi(Chinese Journal of General Practitioners),14(5):377-380(袁华,赵绍杰,龚华,梁喜,王沂峰,2015,腹腔镜下次全子宫与全子宫切除、肌瘤剔除术对子宫肌瘤患者卵巢储备功能的影响,中华全科医师杂志,14(5):377-380)
Zhang X.M.,Wang L.Y.,Lu H.X.,Li J.,and Kong J.Y.,2015,The effect of perioperative nursing in patients with laparoscopic resection of uterine fibroids,Zhongguo Weisheng Biaozhun Guanli(China Health Standard Management),6(21):214-215(张晓梅,王立媛,卢海侠,李婧,孔庆宇,2015,探讨围手术期护理对腹腔镜子宫肌瘤切除患者的干预效果,中国卫生标准管理,6(21):214-215)
Zhao Y.H.,2015,Study on perioperative nursing of patients with uterine fibroids resection,Shiyong Linchuang Yiyao Zazhi(Journal of Clinical Medicine in Practice),11(18):81-84(赵云华,2015,子宫肌瘤切除患者的围术期护理研究,实用临床医药杂志,11(18):81-84)
Zheng C.Q.,Ding X.B.,and Wu F.H.,2014,Application of high-quality nursing interventions in reducing incidence of post-laparoscopy infections and complications,Zhonghua Yiyuan Ganranxue Zazhi(Chinese Journal of Nosocomiology),12(24):160-161(郑超群,丁小波,吴方红,2014,优质护理干预在降低腹腔镜术后感染中的应用,中华医院感染学杂志,12(24):160-161)
Zhi H.,Qin D.H.,Shan C.M.,and Sun J.,2014,Quality care in perioperative cardiovascular surgery applications,Zhongxiyi Jiehe Xinxueguanbing Dianzi Zazhi(Medical Innovation of China),(17):77-79(支慧,秦德华,山慈明,孙静,2014,优质护理服务在心血管外科手术围术期的应用,中西医结合心血管病电子杂志,(17):77-79)