责任制护理模式在胸腔热灌注治疗恶性胸腔积液中的应用效果观察
|
摘要
目的探讨责任制护理模式在胸腔热灌注治疗恶性胸腔积液过程中的应用效果。方法选择2012年9月至2017年5月就诊的78例恶性胸腔积液患者,根据治疗方法不同分为观察组40例与对照组38例。所有患者都给予胸腔热灌注治疗,治疗观察4个周期,对照组给予常规护理,观察组给予责任制护理模式干预。结果观察组总有效率90.0%,对照组68.4%(P<0.05)。2组不良反应有消化道反应、血液系统反应、皮肤反应与心脏毒性等,观察组好于对照组(P<0.05)。治疗后2组的KPS评分都显著高于治疗前(P<0.05),观察组也高于对照组(P<0.05)。观察组的态度、环境、宣教、操作等满意度评分都显著高于对照组(P<0.05)。结论责任制护理模式在胸腔热灌注治疗恶性胸腔积液过程中的应用能提高治疗效果,减少不良反应的发生,提高患者的生活质量,改善护患关系。
Objective To investigate the application effects of the primary nursing model in treatment of malignant pleural effusion by intrapleural hyperthermic perfusion.Methods A total of 78 patients with malignant pleural effusion who were treated in our hospital from September 2012 to May 2017 were enrolled in the study.According to diefferent treatment methods,these patients were divided into observation group(n=40) and control group(n=38).All the patients were treated by intrapleural hyperthermic perfusion, and the patients in control group were given routine nursing,however,the patients in observation group were given the primary nursing intervention,with a treatment course of 4 weeks for both groups. Results The total effective rates in observation group was 90%,which was significantly higher than that(68.4%) in control group(P<0.05). The both groups had adverse effects including gastrointestinal reaction,blood system reaction,skin reaction and cardiac toxicity,however,which in observation group were better than those in control group(P<0.05).After treatment,the KPS scores in both groups were significantly higher than those before treatment(P<0.05),which in observation group were significantly higher than those in control group(P<0.05).Moreover the scores of attitude,environment,propaganda and education,operation satisfaction degree in observation group were significantly higher than those in control group(P<0.05).Conclusion The application of the primary nursing model in treatment of malignant pleural effusion by intrapleural hyperthermic perfusion can improve the therapeutic effects,reduce the occurrence of toxic and adverse effects,improve the life quality of patients and improve the relationship between nurses and patients.
Objective To investigate the application effects of the primary nursing model in treatment of malignant pleural effusion by intrapleural hyperthermic perfusion.Methods A total of 78 patients with malignant pleural effusion who were treated in our hospital from September 2012 to May 2017 were enrolled in the study.According to diefferent treatment methods,these patients were divided into observation group(n=40) and control group(n=38).All the patients were treated by intrapleural hyperthermic perfusion, and the patients in control group were given routine nursing,however,the patients in observation group were given the primary nursing intervention,with a treatment course of 4 weeks for both groups. Results The total effective rates in observation group was 90%,which was significantly higher than that(68.4%) in control group(P<0.05). The both groups had adverse effects including gastrointestinal reaction,blood system reaction,skin reaction and cardiac toxicity,however,which in observation group were better than those in control group(P<0.05).After treatment,the KPS scores in both groups were significantly higher than those before treatment(P<0.05),which in observation group were significantly higher than those in control group(P<0.05).Moreover the scores of attitude,environment,propaganda and education,operation satisfaction degree in observation group were significantly higher than those in control group(P<0.05).Conclusion The application of the primary nursing model in treatment of malignant pleural effusion by intrapleural hyperthermic perfusion can improve the therapeutic effects,reduce the occurrence of toxic and adverse effects,improve the life quality of patients and improve the relationship between nurses and patients.
引文
1 周淑如,李凤娟,刘春红,等.恶性胸腔积液行胸腔闭式引流术的综合护理.陕西医学杂志,2017,46:1319-1320.
2 Huijben JA,Volovici V,Cnossen MC,et al.Variation in general supportive and preventive intensive care management of traumatic brain injury:a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI)study.Crit Care,2018,22:90.
3 郝志梅.胸腔灌注白细胞介素-2与顺铂联合治疗肺癌恶性胸腔积液的疗效与护理分析.海峡药学,2017,18:141-143.
4 Krzykawska-Serda M,Agha MS,Ho JC,et al.Chemotherapy and Radiofrequency-Induced Mild Hyperthermia Combined Treatment of Orthotopic Pancreatic Ductal Adenocarcinoma Xenografts.Transl Oncol,2018,11:664-671.
5 Zaretsky DV,Kline H,Zaretskaia MV,et al.Disinhibiting neurons in the dorsomedial hypothalamus delays the onset of exertional fatigue and exhaustion in rats exercising in a warm environment.Brain Res,2018,15:12-20.
6 姚琴,吴稚冰,马胜林.胸腔循环热灌注化疗恶性胸腔积液的疗效观察和护理.浙江临床医学,2017,19:1162-1163.
7 Kaczmarek K,Hornowski T,Kubovíková M,et al.Heating Induced by Therapeutic Ultrasound in the Presence of Magnetic Nanoparticles.ACS Appl Mater Interfaces,2018,10:11554-11564.
8 郭萍利,孙静岚,刘小娜,等.中心静脉导管引流恶性胸腔积液的临床效果观察.临床医学研究与实践,2016,1:81-82.
9 Kok HP,Navarro F,Strigari L,et al.Locoregional hyperthermia of deep-seated tumours applied with capacitive and radiative systems:a simulation study.Int J Hyperthermia,2018,4:1-17.
10 张爱兰,裴永菊,单海娟,等.同时置入中心静脉导管引流原发性非小细胞肺癌导致恶性胸腔积液的效果观察及护理.现代临床护理,2016,15:44-47.
11 Li X,He M,Wang H.Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit.Medicine(Baltimore),2017,96:e9339.
12 Luo S,Wang Y,Li Z,et al.Establishment and Implementation of Humanistic Nursing Care in Ophthalmic Ward.Eye Sci,2015,30:125-127.
13 wiek D,Przeradzka K,Stanisz M,et al.Analysis of the impact of selected hospital practices on exclusive breastfeeding.Pomeranian J Life Sci,2016,62:25-29.
14 龚兰娟,林万里,陈颖,等.持续循环热灌注法治疗恶性胸腔积液的护理体会.中医临床研究,2017,9:45-46.
15 Yang JP,Xie T,Simoni JM,et al.A Mixed-Methods Study Supporting a Model of Chinese Parental HIV Disclosure.AIDS Behav,2016,20:165-173.
16 Weglicki RS,Reynolds J,Rivers PH.Continuing professional development needs of nursing and allied health professionals with responsibility for prescribing.Nurse Educ Today,2015,35:227-231.
17 马蕊,管静,陈素红,等.综合护理干预对热疗配合化疗治疗恶性胸腹水患者生活质量的影响.中国临床护理,2017,9:234-237.
18 Johansson M,Hildingsson I,Fenwick J.'As long as they are safe--birth mode does not matter' Swedish fathers' experiences of decision-making around caesarean section.Women Birth,2014,27:208-213.
19 夏冬娜.留置中心静脉导管治疗恶性胸腔积液的护理体会.中国现代药物应用,2015,9:209-210.
20 Feng X,Zhu L,Xiong X,et al.Therapeutical effect of intrapleural perfusion with hyperthermic chemotherapy on malignant pleural effusion under video-assisted thoracoscopic surgery.Int J Hyperthermia,2017,7:1-7.
21 Sakaguchi H,Ishida H,Nitanda H,et al.Pharmacokinetic evaluation of intrapleural perfusion with hyperthermic chemotherapy using cisplatin in patients with malignant pleural effusion.Lung Cancer,2017,2:70-74.
22 Gu Y,Jiang L,Miao JH,et al.Clinical effects of thermotherapy in combination with intracavitary infusion of traditional Chinese medicine in the treatment of malignant pleural effusion.J Biol Regul Homeost Agents,2016,30:1023-1028.
23 张小丽,万菲,张新风.注射用核糖核酸Ⅱ联合胸腔热灌注治疗老年恶性胸腔积液的护理研究.国际护理学杂志,2017,36:850-853.
24 Zhou H,Wu W,Tang X,et al.Effect of hyperthermic intrathoracic chemotherapy (HITHOC)on the malignant pleural effusion:A systematic review and meta-analysis.Medicine (Baltimore),2017,96:e5532.
25 鲁文霞.护理干预对洛铂胸腔灌注治疗恶性胸腔积液患者的影响观察.基层医学论坛,2015,21:2741-2742.
2 Huijben JA,Volovici V,Cnossen MC,et al.Variation in general supportive and preventive intensive care management of traumatic brain injury:a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI)study.Crit Care,2018,22:90.
3 郝志梅.胸腔灌注白细胞介素-2与顺铂联合治疗肺癌恶性胸腔积液的疗效与护理分析.海峡药学,2017,18:141-143.
4 Krzykawska-Serda M,Agha MS,Ho JC,et al.Chemotherapy and Radiofrequency-Induced Mild Hyperthermia Combined Treatment of Orthotopic Pancreatic Ductal Adenocarcinoma Xenografts.Transl Oncol,2018,11:664-671.
5 Zaretsky DV,Kline H,Zaretskaia MV,et al.Disinhibiting neurons in the dorsomedial hypothalamus delays the onset of exertional fatigue and exhaustion in rats exercising in a warm environment.Brain Res,2018,15:12-20.
6 姚琴,吴稚冰,马胜林.胸腔循环热灌注化疗恶性胸腔积液的疗效观察和护理.浙江临床医学,2017,19:1162-1163.
7 Kaczmarek K,Hornowski T,Kubovíková M,et al.Heating Induced by Therapeutic Ultrasound in the Presence of Magnetic Nanoparticles.ACS Appl Mater Interfaces,2018,10:11554-11564.
8 郭萍利,孙静岚,刘小娜,等.中心静脉导管引流恶性胸腔积液的临床效果观察.临床医学研究与实践,2016,1:81-82.
9 Kok HP,Navarro F,Strigari L,et al.Locoregional hyperthermia of deep-seated tumours applied with capacitive and radiative systems:a simulation study.Int J Hyperthermia,2018,4:1-17.
10 张爱兰,裴永菊,单海娟,等.同时置入中心静脉导管引流原发性非小细胞肺癌导致恶性胸腔积液的效果观察及护理.现代临床护理,2016,15:44-47.
11 Li X,He M,Wang H.Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit.Medicine(Baltimore),2017,96:e9339.
12 Luo S,Wang Y,Li Z,et al.Establishment and Implementation of Humanistic Nursing Care in Ophthalmic Ward.Eye Sci,2015,30:125-127.
13 wiek D,Przeradzka K,Stanisz M,et al.Analysis of the impact of selected hospital practices on exclusive breastfeeding.Pomeranian J Life Sci,2016,62:25-29.
14 龚兰娟,林万里,陈颖,等.持续循环热灌注法治疗恶性胸腔积液的护理体会.中医临床研究,2017,9:45-46.
15 Yang JP,Xie T,Simoni JM,et al.A Mixed-Methods Study Supporting a Model of Chinese Parental HIV Disclosure.AIDS Behav,2016,20:165-173.
16 Weglicki RS,Reynolds J,Rivers PH.Continuing professional development needs of nursing and allied health professionals with responsibility for prescribing.Nurse Educ Today,2015,35:227-231.
17 马蕊,管静,陈素红,等.综合护理干预对热疗配合化疗治疗恶性胸腹水患者生活质量的影响.中国临床护理,2017,9:234-237.
18 Johansson M,Hildingsson I,Fenwick J.'As long as they are safe--birth mode does not matter' Swedish fathers' experiences of decision-making around caesarean section.Women Birth,2014,27:208-213.
19 夏冬娜.留置中心静脉导管治疗恶性胸腔积液的护理体会.中国现代药物应用,2015,9:209-210.
20 Feng X,Zhu L,Xiong X,et al.Therapeutical effect of intrapleural perfusion with hyperthermic chemotherapy on malignant pleural effusion under video-assisted thoracoscopic surgery.Int J Hyperthermia,2017,7:1-7.
21 Sakaguchi H,Ishida H,Nitanda H,et al.Pharmacokinetic evaluation of intrapleural perfusion with hyperthermic chemotherapy using cisplatin in patients with malignant pleural effusion.Lung Cancer,2017,2:70-74.
22 Gu Y,Jiang L,Miao JH,et al.Clinical effects of thermotherapy in combination with intracavitary infusion of traditional Chinese medicine in the treatment of malignant pleural effusion.J Biol Regul Homeost Agents,2016,30:1023-1028.
23 张小丽,万菲,张新风.注射用核糖核酸Ⅱ联合胸腔热灌注治疗老年恶性胸腔积液的护理研究.国际护理学杂志,2017,36:850-853.
24 Zhou H,Wu W,Tang X,et al.Effect of hyperthermic intrathoracic chemotherapy (HITHOC)on the malignant pleural effusion:A systematic review and meta-analysis.Medicine (Baltimore),2017,96:e5532.
25 鲁文霞.护理干预对洛铂胸腔灌注治疗恶性胸腔积液患者的影响观察.基层医学论坛,2015,21:2741-2742.