膀胱癌术后膀胱内灌注化疗患者的症状特征及困扰分析  

Analysis on the characteristics and distress of symptoms in patients with bladder perfusion chemotherapy after resection of bladder cancer

作　　者：王小英[1] 张文玲[1] 赖伟红[1] 霍斯文 何旋[1] 

机构地区：[1]广东省高州市人民医院泌尿外科一区,525200

出　　处：《中华现代护理杂志》2015年第17期2032-2036,共5页Chinese Journal of Modern Nursing

基　　金：茂名市科技计划项目社会发展类项目（20130331）

摘　　要：目的：分析膀胱癌经尿道膀胱肿瘤电切术后患者膀胱灌注化疗期间的症状及其对患者的困扰程度及特点，探讨患者不适症状的个体化干预方法。方法应用自编一般资料调查表、M. D. Anderson症状调查量表及增补条目，对84例膀胱癌术后膀胱灌注化疗患者进行调查分析。个体化干预后观察患者症状的改善情况。结果患者术后膀胱灌注化疗期间的症状分量表平均得分（3.12±1.02）分，属轻度；症状分量表条目得分排序前5位依次是胃口差、疲劳乏力、睡眠不安、恶心、呕吐。困扰分量表平均得分（2.85±2.02）分，属轻度；困扰分量表条目得分从高到低依次为工作、情绪、一般活动、生活乐趣、行走、人际关系。增补条目得分依次是膀胱内烧灼感、膀胱刺激征、胃肠道反应。给予个体化干预后患者部分症状评分明显下降（P〈0.05）。结论膀胱癌经尿道膀胱肿瘤电切术后患者膀胱灌注化疗期间普遍存在症状困扰，提示应根据患者症状困扰的特点进行个体化干预，以缓解其症状困扰。Objective To discuss the extent and characteristics of symptoms and symptom distress, and find the individualized management for patients undergoing bladder perfusion chemotherapy after transurethral bladder resection of bladder tumor. Methods The general information questionnaire, M. D. Anderson Symptom Inventory （ MDASI） and additional entries were used to investigate 84 patients undergoing bladder perfusion chemotherapy after transurethral bladder resection of bladder tumor. After individualized treatment, scores of symptoms were observed. Results Symptom score of patients in this group was （3. 12 ± 1. 02）, which was at the mild level. Symptoms subscale score entries sorted successively as poor appetite, fatigue, disturbed sleep, nausea, and vomiting. Symptom distress score was （2. 85 ± 2. 02）, which was at the mild level. Distress subscale score in the order of entries were work, mood and general activity, enjoyment of life, walking and relationship. Added entries score in the order were burning sensation in the bladder, bladder irritation and gastrointestinal reactions. Scores of some symptoms were significantly lower than before （ P 〈 0. 05 ）. Conclusions Symptom distress is prevalent in patients undergoing bladder perfusion chemotherapy after transurethral bladder resection of bladder tumor, prompting that the intervention should be individualized according to the patient′s symptom distress features to alleviate their symptoms distress.

关 键 词：膀胱肿瘤 膀胱灌注 化疗 症状困扰 个体化干预 

分 类 号：R473.73[医药卫生—护理学]