延续性干预措施对结直肠癌造口患者术后预后与心理状态影响的分析  

Effects of continuous interventions on postoperative prognosis and mental state of colorectal cancer patients with stoma

作　　者：倪建琴 黄玲玲 蒋大艳 王传思[2] 

机构地区：[1]六安市人民医院胃肠外科,安徽六安2370050 [2]六安市人民医院普外科,安徽六安2370050

出　　处：《癌症进展》2018年第2期258-261,共4页Oncology Progress

摘　　要：目的探讨延续性干预措施对结直肠癌造口患者术后预后和心理状态的影响。方法选择80例行永久肠造口术的结直肠癌患者,按照随机数字表法分为对照组和观察组,每组40例。对照组患者进行常规护理,观察组患者进行延续性护理。比较两组患者的相关知识技能掌握情况、并发症发生情况、生活质量和心理状态。结果观察组患者对复诊延续、饮食注意、并发症处理、造口袋更换知识和技能的掌握情况均优于对照组,差异有统计学意义(P﹤0.05)。护理前,两组患者的5项生活质量评分(身体状况、生活状态、情感状态、社会方面和自我能力)比较,差异均无统计学意义(P﹥0.05);出院1年后,两组患者的生活质量均明显改善,其中观察组患者的5项生活质量评分均明显高于对照组,差异均有统计学意义(P﹤0.01)。在随访1年内,观察组患者的并发症的总发生率低于对照组,差异有统计学意义(P﹤0.05)。护理前,两组患者的汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分比较,差异无统计学意义(P﹥0.05);出院后1年,两组患者的HAMA和HAMD评分均改善,其中观察组患者的HAMA和HAMD评分均明显低于对照组,差异有统计学意义(P﹤0.01)。结论延续性护理可以有效地减少结直肠癌造口患者并发症的发生率,改善患者的生活质量和心理状态。Objective To investigate the effects of continuous interventions on the postoperative prognosis and mental state of colorectal cancer patients administered with enterostomy. Method 80 colorectal cancer patients who underwent permanent enterostomy were randomized as study group and control group with 40 patients in each, according to a random number table. The patients in control group were treated with routine care and those in study group were administered with continuous interventions. The relevant knowledge and skills of clinical care, occurrence of complications, quality of life and mental state of the two groups were compared. Result The mastery of knowledge and skills regarding subsequent visits, diet, management of complications, replacing the enterostomy pouches of the study group was significantly better than that of the control group, the difference was significantly significant（P〈0.05）. Before clinical care, there were no significant differences in the five quality of life（physical conditions, life status, emotional status, social aspects and self ability） scores between the two groups（P〉0.05）; while 1 year after discharge, the quality of life in both groups were significantly improved, besides, the five quality of life scores of the study group were significantly higher than those of the control group, the difference was significantly significant（P〈0.01）. During the 1-year follow-up, the incidence of complications was lower in study group than in control group, the difference was significantly significant（P〈0.05）. Hamilton Anxiety Scale（HAMA） and Hamilton Depression Scale（HAMD） scores were also similar between the two groups before treatment and there were no significant differences（P〉0.05）; and were significantly improved in 1 year after discharge, while those of study group were significantly lower than in control group, the difference was significantly significant（P〈0.01）. Conclusion Continuous care can effectively reduce the incidence of complication

关 键 词：延续性护理 结直肠癌 肠造口 心理状态 

分 类 号：R735.3[医药卫生—肿瘤]