中医护理干预对乳腺癌患者术后并发症及生活质量的影响
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摘要
目的:探讨中医护理干预对乳腺癌患者术后并发症及生活质量的影响。方法:将122例乳腺癌术后患者随机均分为2组,对照组给予常规护理,观察组在常规护理的基础上进行中医饮食调护、穴位调理、情志疏导等中医护理干预,比较2组干预前后并发症发生率、伴随症状发生率、肩关节功能障碍的发生情况及生活质量评分。结果:生活质量评分治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较差异也有统计学意义(P<0.05)。术后并发症(患肢水肿、皮瓣坏死、皮下积液等)发生率2组比较,差异无统计学意义(P>0.05)。术后7天时2组伴随症状发生率比较,差异有统计学意义(P<0.05)。术后3个月2组肩关节功能障碍的发生程度比较,差异有统计学意义(P<0.05)。结论:中医护理干预有利于降低乳腺癌患者术后伴随症状的发生率,改善肩关节功能,提高生活质量。
Objective: To discuss the effects of TCM nursing intervention on postoperative complications and quality of life of the patients suffering mammary cancer. Methods: All 122 patients were randomized into two groups, the control group accepted conventional care, while the observation group TCM nursing intervention including TCM dietary regulation, acupoints regulation, emotional guidance and others based on conventional care,to compare the incidence of postoperative complications, the incidence of accompanying symptoms, shoulder joint functional dysfunction and the scores of quality of life before and after the intervention between both groups.Results: The difference had statistical meaning in the score of quality of life within two groups before and after treating(P<0.05), the difference was statistically significant in the comparisons between both groups after treating(P <0.05). The difference had no statistical meaning in the comparisons of the incidences of postoperative complications(edema of affected limb, skin flap necrosis, subcutaneous fluid retention) between both groups(P>0.05).The difference had statistical meaning in the incidences of accompanying symptoms between both groups in seven days after the operation(P<0.05). The difference was statistically significant in the comparisons of shoulder joint functional dysfunction in three months after the operation(P <0.05). Conclusion: TCM nursing intervention is helpful to lower the incidence of accompanying symptoms of the patients, improve joint functional dysfunction and raise quality of life.
Objective: To discuss the effects of TCM nursing intervention on postoperative complications and quality of life of the patients suffering mammary cancer. Methods: All 122 patients were randomized into two groups, the control group accepted conventional care, while the observation group TCM nursing intervention including TCM dietary regulation, acupoints regulation, emotional guidance and others based on conventional care,to compare the incidence of postoperative complications, the incidence of accompanying symptoms, shoulder joint functional dysfunction and the scores of quality of life before and after the intervention between both groups.Results: The difference had statistical meaning in the score of quality of life within two groups before and after treating(P<0.05), the difference was statistically significant in the comparisons between both groups after treating(P <0.05). The difference had no statistical meaning in the comparisons of the incidences of postoperative complications(edema of affected limb, skin flap necrosis, subcutaneous fluid retention) between both groups(P>0.05).The difference had statistical meaning in the incidences of accompanying symptoms between both groups in seven days after the operation(P<0.05). The difference was statistically significant in the comparisons of shoulder joint functional dysfunction in three months after the operation(P <0.05). Conclusion: TCM nursing intervention is helpful to lower the incidence of accompanying symptoms of the patients, improve joint functional dysfunction and raise quality of life.
引文
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[9]李茂林,孙显峰.益气升白汤治疗乳腺癌化疗后白细胞减少症109例[J].陕西中医,2010,31(2):182-184.
[10]李思蒙,杨郁文,汪永坚.艾灸预防乳腺癌术后患肢淋巴水肿的效果观察[J].护理与康复,2012,11(4):362-363.
[11]沈群,王波,金春蕾.吴茱萸穴位贴敷涌泉穴治疗失眠的研究进展[J].环球中医药,2013,12(6):48-49.
[12]陈霞.中医情志护理在老年性肺心病患者护理中的体会[J].新中医2013,45(6):214-215.
[13]孙红,王浩,马瑾璐,等.乳腺癌病人的心理健康状况及应对对策[J].中国医学伦理学,2006,19(2):99-100.
[14]李树玲.乳腺肿瘤学[M].北京:科学技术文献出版社,2000:422-693.
[15]Rutqvistl E,Bergkvist L,Frisell J,et al.A randomized study of axillary drainage and pectoral fascia preservation after mastectomy for brest cancer[J].Eur J Surg Oncol,2004,30(6):602-609.
[16]李磊,阿迪力江·买买提明,地力木拉提·艾斯木吐拉.乳腺癌改良根治术后皮下积液与皮瓣坏死的原因及防治探讨[J].中国普外基础与临床杂志,2015,22(6):725-728.
[17]祝亚男,俞国红,杨方英,等.中医护理技术对减少乳腺癌患者术后并发症的效果研究[J].中华护理杂志,2017,52(3):289-292.
[18]孙放,郭淳,孙行云,等.乳腺癌的中医药治疗进展[J].广西中医药大学学报,2014,17(4):87-89.
[19]罗帅,艾一玖.心理辅导在乳腺癌患者术后辅导中的应用[J].现代中西医结合杂志[J].2014,23(6):661-663.
[20]马云飞,孙旭,杨永,等.乳腺癌的中医证型及用药规律研究[J].西部中医药,2017,30(1):46-48.
[21]黄耀梅,陆松华.乳腺癌术后患者心理分阶段转变护理的效果评价[J].西部中医药,2017,30(2):116-118.
[22]白白.涌泉穴临床应用概况实用[J].中医药杂志,2012,28(7):614-615.
[23]孔咏霞.乳腺癌中医证型与证候要素分布规律文献研究[J].西部中医药,2018,31(3):68-71.
[24]陈锡康,田华琴.三阴性乳腺癌的治疗现状及进展[J].西部中医药,2018,31(11):135-140.
[25]杨传英,李俊峰.吴茱萸临床应用琐谈[J].上海中医药杂志,2012,46(5):77-78.
[26]熊园林,任晓军,杨颖宇.益气温阳方联合CEF方案对乳腺癌患者生活质量和免疫功能的影响[J].中医药信息,2016,24(6):70-74.
[27]吴继萍,冯妮,李艺,等.乳清汤干预乳腺癌气阴亏虚证性激素水平的试验研究[J].中医药信息,2016,24(1):53-56.
[28]李佩欣.情志疗法在乳腺癌治疗中的应用之临床研究[D].南京:南京中医药大学,2010.
[29]刚宏林,马跃,马英南,等.玻璃苣生物碱提取工艺与抗乳腺癌药效学研究[J].中医药信息,2016,24(3):33-36.
[2]庞华琼,章霞.护理干预对乳腺癌患者焦虑、抑郁状态的影响[J].现代临床护理,2008,7(3):15-17.
[3]陈宁.乳腺癌患者失眠影响因素分析及中医护理干预[J].云南中医药杂志,2014,35(7):80-82.、
[4]穆丽波,姜潮,刘海燕.影响乳腺癌患者生活质量的心理方面因素[J].国外医学:社会医学分册,2001,18(4):157-160.
[5]付岚,李俊英,李虹,等.社会支持与癌症患者生活质量的相关性研究及护理对策[J].中华护理杂志,2004,39(1):9-11.
[6]石元凯,孙燕.临床肿瘤内科手册[M].北京:人民卫生出版社,2016:343-348.
[7]张昌政,禤翠玲.肝郁痰凝型乳腺癌的钼靶X线表现及病理分析[J].山西中医,2006,22(6):50-51.
[8]张红霞.乳腺癌术后患者生活质量的影响因素分析[J].解放军护理杂志,2007,24(3):45-46.
[9]李茂林,孙显峰.益气升白汤治疗乳腺癌化疗后白细胞减少症109例[J].陕西中医,2010,31(2):182-184.
[10]李思蒙,杨郁文,汪永坚.艾灸预防乳腺癌术后患肢淋巴水肿的效果观察[J].护理与康复,2012,11(4):362-363.
[11]沈群,王波,金春蕾.吴茱萸穴位贴敷涌泉穴治疗失眠的研究进展[J].环球中医药,2013,12(6):48-49.
[12]陈霞.中医情志护理在老年性肺心病患者护理中的体会[J].新中医2013,45(6):214-215.
[13]孙红,王浩,马瑾璐,等.乳腺癌病人的心理健康状况及应对对策[J].中国医学伦理学,2006,19(2):99-100.
[14]李树玲.乳腺肿瘤学[M].北京:科学技术文献出版社,2000:422-693.
[15]Rutqvistl E,Bergkvist L,Frisell J,et al.A randomized study of axillary drainage and pectoral fascia preservation after mastectomy for brest cancer[J].Eur J Surg Oncol,2004,30(6):602-609.
[16]李磊,阿迪力江·买买提明,地力木拉提·艾斯木吐拉.乳腺癌改良根治术后皮下积液与皮瓣坏死的原因及防治探讨[J].中国普外基础与临床杂志,2015,22(6):725-728.
[17]祝亚男,俞国红,杨方英,等.中医护理技术对减少乳腺癌患者术后并发症的效果研究[J].中华护理杂志,2017,52(3):289-292.
[18]孙放,郭淳,孙行云,等.乳腺癌的中医药治疗进展[J].广西中医药大学学报,2014,17(4):87-89.
[19]罗帅,艾一玖.心理辅导在乳腺癌患者术后辅导中的应用[J].现代中西医结合杂志[J].2014,23(6):661-663.
[20]马云飞,孙旭,杨永,等.乳腺癌的中医证型及用药规律研究[J].西部中医药,2017,30(1):46-48.
[21]黄耀梅,陆松华.乳腺癌术后患者心理分阶段转变护理的效果评价[J].西部中医药,2017,30(2):116-118.
[22]白白.涌泉穴临床应用概况实用[J].中医药杂志,2012,28(7):614-615.
[23]孔咏霞.乳腺癌中医证型与证候要素分布规律文献研究[J].西部中医药,2018,31(3):68-71.
[24]陈锡康,田华琴.三阴性乳腺癌的治疗现状及进展[J].西部中医药,2018,31(11):135-140.
[25]杨传英,李俊峰.吴茱萸临床应用琐谈[J].上海中医药杂志,2012,46(5):77-78.
[26]熊园林,任晓军,杨颖宇.益气温阳方联合CEF方案对乳腺癌患者生活质量和免疫功能的影响[J].中医药信息,2016,24(6):70-74.
[27]吴继萍,冯妮,李艺,等.乳清汤干预乳腺癌气阴亏虚证性激素水平的试验研究[J].中医药信息,2016,24(1):53-56.
[28]李佩欣.情志疗法在乳腺癌治疗中的应用之临床研究[D].南京:南京中医药大学,2010.
[29]刚宏林,马跃,马英南,等.玻璃苣生物碱提取工艺与抗乳腺癌药效学研究[J].中医药信息,2016,24(3):33-36.