奥马哈系统在TACE治疗中晚期肝癌患者护理中的应用效果  

The application of Omaha system in the clinical nursing for patients with advanced hepatocellular carcinoma treated with TACE

作　　者：毛剑婷[1] 黄旭芳[1] 纪建松[1] 吴徐璐 刘丽霞[1] 李芳[1] 陈淑霞[1] MAO Jianting HUANG Xufang JI Jiansong WU Xulu LIU Lixia LI Fang CHENG Shuxia.(Interventional Diagnosis and Treatment Center, Lishui Municipal Central Hospital, Affiliated Lishui Hospital of Zhejiang University, Affiliated Fifth Hospital of Wenzhou Medical University, Lishui, Zhejiang Province 323000, Chin)

机构地区：[1]丽水市中心医院(浙江大学丽水医院,温州医科大学附属第五医院)介入诊疗中心,浙江323000

出　　处：《介入放射学杂志》2017年第7期660-664,共5页Journal of Interventional Radiology

基　　金：浙江省重大科技专项重大社会发展项目(2013C03010);丽水市科技局科技自筹项目(2014ZC028)

摘　　要：目的探讨基于奥马哈系统的针对性护理,在中晚期肝癌肝动脉化疗栓塞(TACE)护理中的临床应用价值。方法前瞻性地将60例拟用TACE治疗的中晚期肝癌患者随机分为对照组(n=30)和观察组(n=30)。对照组实施常规护理模式,观察组实施奥马哈系统护理模式,观察组患者在入院时通过奥马哈系统进行评估,筛选出关键的共性问题进行针对性护理,同时两组患者在入院当天、出院当天填写汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、社会支持评定量表(SSQ)、数字疼痛评分表(NRS),分别评估抑郁、焦虑、社会支持和疼痛程度。结果两种护理模式均能改善患者抑郁、焦虑状况,完善患者社会支持系统,但观察组在这两方面疗效明显优于对照组(P<0.05),同时发现两种护理模式对于患者疼痛程度改善差异无统计学意义,但基于奥马哈系统的护理模式在一定程度上能够缓解患者疼痛。结论奥马哈系统在中晚期肝癌患者TACE护理中,能够缓解患者负性情绪,并促进患者社会支持系统构建,且优于常规护理,在临床上有较大应用潜力。Objective To discuss the clinical nursing care for patients with hepatocellular carcinoma application value of Omaha system-based targeting （HCC） who were treated with transcatheter arterial chemoembolization （TACE）. Methods A total of 60 advanced HCC patients, who were planned to receive TACE, were prospectively and randomly divided into the control group （n=30） and the observation group （n= 30）. Routine nursing mode was adopted for the patients in the control group, while Omaha system nursing model was employed for the patients in the observation group. The patients of the observation group were evaluated with Omaha system at the time of admission, the key common problems were screened out and targeted nursing measures were employed. Meanwhile, on the days of admission and discharge all the patients of both groups were asked to fill in the forms of Hamilton depression scale （HAMD-17）, Hamilton anxiety scale （HAMA）, social support rating scale （SSQ） and numerical pain rating scale （NRS） ; and the degrees of depression, anxiety, social support and pain were respectively assessed. Results Both nursing modes could improve the degrees of depression and anxiety as well as the social support system of HCC patients, but the curative effect of these two aspects in the observation group were obviously better than those in the control group （P〈0.05）. No statistically significant difference in the improvement of pain degree existed between the two nursing models, but Omaha system-based targeting nursing mode could alleviate the patient＇s pain to a certain extent. Conclusion For patients with advanced HCC, Omaha system-based targeting nursing care can alleviate the patient＇s negative emotion and promote the patients to establish effective social support system, this nursing mode is superior to conventional nursing mode. Therefore, Omaha system-based targeting nursing has great application potential in clinical practice.

关 键 词：奥马哈系统 中晚期肝癌 针对性护理 常规护理 负面情绪 

分 类 号：R473.73[医药卫生—护理学]