循证护理在膀胱癌患者腹壁造口术后护理中的应用价值
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摘要
目的针对膀胱癌患者生活质量下降的问题,探究循证护理在膀胱癌患者腹壁造口术后护理中的应用价值。方法选取2015年11月—2017年11月在丽水市人民医院接受治疗的膀胱癌患者170例,按随机数字表法随机分为联合护理组和常规护理组,每组各85例,2组患者均采用腹壁造口术进行治疗。常规性护理组患者采取常规护理手段进行护理,联合护理组在常规护理组的护理基础上使用循证护理。检测Bax蛋白和Bcl-2蛋白表达;对2组患者护理前后进行SAS、SDS评分;对2组患者护理前后腹壁造口相关知识熟悉程度、生活质量进行评价;统计对比2组患者住院时间、护理质量及家属满意度。结果护理后联合护理组Bcl-2水平低于常规护理组(P=0.001),Bax水平高于常规护理组(P=0.003);护理后联合护理组患者SAS、SDS评分低于常规护理组(P=0.004);护理后联合护理组患者腹壁造口相关知识掌握程度优于常规护理组(P=0.016);护理后联合护理组患者生活质量评分高于常规护理组(P=0.004);联合护理组患者住院时间低于常规护理组(P=0.012);联合护理组护理质量优于常规护理组(P=0.002),联合护理组患者家属满意度高于常规护理组(P=0.039)。结论循证护理能够明显改善膀胱癌患者腹壁造口术后生活质量,促进患者身体恢复,具有较高的临床应用价值。
Objective To explore the application value of evidence-based nursing in nursing care of patients with bladder cancer after abdominal stoma. Methods A total of 170 cases of bladder cancer who were treated in our hospital from November,2015 to November,2017 were randomly divided into two groups with 85 cases in the combined nursing group and the conventional nursing group respectively and the two groups were treated with abdominal wall stoma. The patients in the routine nursing group received routine nursing care,and the combined nursing group used evidence-based nursing on the basis of the routine nursing group. The expression of Bax protein and Bcl-2 protein were detected,SAS and SDS were scored before and after nursing in the two groups,and the knowledge familiarity and quality of life of the abdominal stoma before and after the nursing of the two groups were evaluated. The time of hospitalization,the quality of nursing and the satisfaction of the family members were compared. Results After nursing,the level of Bcl-2 in the combined nursing group was lower than that of the conventional nursing group( P = 0. 001),and the level of Bax was higher than that of the conventional nursing group( P = 0. 003); the SAS and SDS scores of the patients in the combined nursing group after nursing were lower than those of the conventional nursing group( P = 0. 004),and the degree of knowledge of abdominal stoma related knowledge in the patients after nursing was better than that of the conventional nursing group( P = 0. 016).The quality of life of the combined nursing group was higher than that of the conventional nursing group( P = 0. 004),the hospitalization time of the combined nursing group was lower than that of the conventional nursing group( P = 0. 012),and the nursing quality of the combined nursing group was better than that of the conventional nursing group( P =0. 002),and the family satisfaction of the patients with the joint nursing group was higher than that of the conventional nursing group( P = 0. 039). Conclusion Evidence-based nursing can significantly improve the quality of life of patients with bladder cancer after abdominal stoma,and promote the recovery of patients' body,which has a high clinical value.
Objective To explore the application value of evidence-based nursing in nursing care of patients with bladder cancer after abdominal stoma. Methods A total of 170 cases of bladder cancer who were treated in our hospital from November,2015 to November,2017 were randomly divided into two groups with 85 cases in the combined nursing group and the conventional nursing group respectively and the two groups were treated with abdominal wall stoma. The patients in the routine nursing group received routine nursing care,and the combined nursing group used evidence-based nursing on the basis of the routine nursing group. The expression of Bax protein and Bcl-2 protein were detected,SAS and SDS were scored before and after nursing in the two groups,and the knowledge familiarity and quality of life of the abdominal stoma before and after the nursing of the two groups were evaluated. The time of hospitalization,the quality of nursing and the satisfaction of the family members were compared. Results After nursing,the level of Bcl-2 in the combined nursing group was lower than that of the conventional nursing group( P = 0. 001),and the level of Bax was higher than that of the conventional nursing group( P = 0. 003); the SAS and SDS scores of the patients in the combined nursing group after nursing were lower than those of the conventional nursing group( P = 0. 004),and the degree of knowledge of abdominal stoma related knowledge in the patients after nursing was better than that of the conventional nursing group( P = 0. 016).The quality of life of the combined nursing group was higher than that of the conventional nursing group( P = 0. 004),the hospitalization time of the combined nursing group was lower than that of the conventional nursing group( P = 0. 012),and the nursing quality of the combined nursing group was better than that of the conventional nursing group( P =0. 002),and the family satisfaction of the patients with the joint nursing group was higher than that of the conventional nursing group( P = 0. 039). Conclusion Evidence-based nursing can significantly improve the quality of life of patients with bladder cancer after abdominal stoma,and promote the recovery of patients' body,which has a high clinical value.
引文
[1]丁丽丽,黄玲莎,叶俭,等.尿膀胱肿瘤抗原在膀胱癌中的表达及意义[J].中国现代医学杂志,2017,27(6):106-109.
[2]赵艳华.延续性护理对膀胱癌腹壁造口术后患者负性情绪和生活质量的影响[J].实用临床医药杂志,2016,20(6):64-66.
[3]纪翠雅,何淑波.综合护理干预对膀胱肿瘤手术泌尿造口患者生活质量的影响[J].海南医学,2015,26(3):454-455,456.
[4]李朝煜,牛玉婷,王薇,等.关注循证实践本质的循证护理模式研究进展[J].中国护理管理,2017,17(12):1720-1725.
[5]韩苏军,张思维,陈万青,等.中国膀胱癌发病现状及流行趋势分析[J].癌症进展,2013,11(1):89-95.
[6]乔菲.术前造口定位对膀胱癌尿流改道腹壁造口患者生活质量的影响[J].中国煤炭工业医学杂志,2013,16(12):2009-2010.
[7]Park JC,Hahn NM.Bladder cancer:a disease ripe for major advances[J].Clin Adv Hematol Oncol,2014,12(12):838-845.
[8]商昌欢.膀胱肿瘤的手术治疗与疗效分析[J].河北医学,2013,19(3):432-434.
[9]朱丹.膀胱癌患者行根治性膀胱全切术腹壁造口术后的护理[J].贵州医药,2017,41(8):894-895.
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[11]尹智勇,杨俊元,祁宏.Bcl-2蛋白质家族调控细胞凋亡机制的研究进展[J].信阳师范学院学报(自然科学版),2017,30(2):340-344.
[12]Gioacchini FM,Alicandri-Ciufelli M,Rubini C,et al.Prognostic value of Bcl-2 expression in squamous cell carcinoma of the larynx:a systematic review[J].Int J Biol Markers,2015,30(2):e155-160.
[13]郭巍,陈美霓,王爱红,等.P53、Bcl-2和Bax在膀胱癌的表达及意义[J].山西医科大学学报,2014,45(3):180-183,248.
[14]王长林,任明华.膀胱癌细胞系中诱变型内皮抑素对Bcl-2蛋白表达影响的研究[J].哈尔滨医科大学学报,2017,51(2):104-108.
[15]李佩云,李春芳,孙力.高压氧疗法对颅脑损伤患者BI指数、GCS、SAS、SDS的影响[J].海南医学院学报,2017,23(16):2289-2291,2295.
[16]纪敏,叶永秀.中药食疗配合延续性护理对中老年糖尿病患者SAS、SDS、SES评分及血糖水平的影响[J].湖北中医药大学学报,2017,19(3):63-66.
[17]瞿春华,瞿海红,周花仙.尿流改道腹壁造口术后病人延续护理的研究现状[J].护理研究,2017,31(26):3221-3225.
[18]Morales-Mendoza Y,Fernández-Martínez R,Fabián-Victoriano MR,et al.Candida species isolation in peristomal skin in patients with abdominal stomas and correlation to clinical signs:a descriptive pilot study[J].Adv Skin Wound Care,2014,27(11):500-504.
[19]Brenda Nevidjon,卢美玲.肿瘤护理的循证实践[J].护士进修杂志,2017,32(14):1249-1252.
[20]杨丽君,余洋.循证护理在膀胱全切原位回肠代膀胱术治疗患者中的应用研究[J].检验医学与临床,2016,13(20):2951-2952.
[2]赵艳华.延续性护理对膀胱癌腹壁造口术后患者负性情绪和生活质量的影响[J].实用临床医药杂志,2016,20(6):64-66.
[3]纪翠雅,何淑波.综合护理干预对膀胱肿瘤手术泌尿造口患者生活质量的影响[J].海南医学,2015,26(3):454-455,456.
[4]李朝煜,牛玉婷,王薇,等.关注循证实践本质的循证护理模式研究进展[J].中国护理管理,2017,17(12):1720-1725.
[5]韩苏军,张思维,陈万青,等.中国膀胱癌发病现状及流行趋势分析[J].癌症进展,2013,11(1):89-95.
[6]乔菲.术前造口定位对膀胱癌尿流改道腹壁造口患者生活质量的影响[J].中国煤炭工业医学杂志,2013,16(12):2009-2010.
[7]Park JC,Hahn NM.Bladder cancer:a disease ripe for major advances[J].Clin Adv Hematol Oncol,2014,12(12):838-845.
[8]商昌欢.膀胱肿瘤的手术治疗与疗效分析[J].河北医学,2013,19(3):432-434.
[9]朱丹.膀胱癌患者行根治性膀胱全切术腹壁造口术后的护理[J].贵州医药,2017,41(8):894-895.
[10]任玉伟,宿华威.Bcl-2基因家族研究进展[J].大连医科大学学报,2015,37(2):202-205.
[11]尹智勇,杨俊元,祁宏.Bcl-2蛋白质家族调控细胞凋亡机制的研究进展[J].信阳师范学院学报(自然科学版),2017,30(2):340-344.
[12]Gioacchini FM,Alicandri-Ciufelli M,Rubini C,et al.Prognostic value of Bcl-2 expression in squamous cell carcinoma of the larynx:a systematic review[J].Int J Biol Markers,2015,30(2):e155-160.
[13]郭巍,陈美霓,王爱红,等.P53、Bcl-2和Bax在膀胱癌的表达及意义[J].山西医科大学学报,2014,45(3):180-183,248.
[14]王长林,任明华.膀胱癌细胞系中诱变型内皮抑素对Bcl-2蛋白表达影响的研究[J].哈尔滨医科大学学报,2017,51(2):104-108.
[15]李佩云,李春芳,孙力.高压氧疗法对颅脑损伤患者BI指数、GCS、SAS、SDS的影响[J].海南医学院学报,2017,23(16):2289-2291,2295.
[16]纪敏,叶永秀.中药食疗配合延续性护理对中老年糖尿病患者SAS、SDS、SES评分及血糖水平的影响[J].湖北中医药大学学报,2017,19(3):63-66.
[17]瞿春华,瞿海红,周花仙.尿流改道腹壁造口术后病人延续护理的研究现状[J].护理研究,2017,31(26):3221-3225.
[18]Morales-Mendoza Y,Fernández-Martínez R,Fabián-Victoriano MR,et al.Candida species isolation in peristomal skin in patients with abdominal stomas and correlation to clinical signs:a descriptive pilot study[J].Adv Skin Wound Care,2014,27(11):500-504.
[19]Brenda Nevidjon,卢美玲.肿瘤护理的循证实践[J].护士进修杂志,2017,32(14):1249-1252.
[20]杨丽君,余洋.循证护理在膀胱全切原位回肠代膀胱术治疗患者中的应用研究[J].检验医学与临床,2016,13(20):2951-2952.