图文式临床护理路径用于甲状腺癌术后大剂量^(131)I治疗中的效果观察  

Application of graph-based clinical nursing pathway for postoperative thyroid cancer patients with high-dose iodine-131 treatment

作　　者：施海燕 张晨 SHI Haiyan;ZHANG Chen(Department of Nuclear Medicine,The First Affiliated Hospital with Nanjing Medical University,Nanjing,Jiangsu,210029)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院核医学科,江苏南京210029

出　　处：《中西医结合护理（中英文）》2018年第5期4-7,共4页Journal of Clinical Nursing in Practice

基　　金：国家临床重点专科建设项目(2100299)

摘　　要：目的探讨图文式临床护理路径应用于甲状腺癌术后大剂量^(131)I治疗中的效果。方法选取2015年7月—2016年7月收治的甲状腺癌术后行大剂量^(131)I治疗患者52例设为对照组,接受常规护理和健康教育。选取2016年8月—2017年8月收治的甲状腺癌术后行大剂量^(131)I治疗患者52例设为研究组,接受图文式临床护理路径干预。对比2组护理干预前后负性情绪和生活质量变化,统计2组并发症发生率情况。结果实施护理干预后,研究组汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分分别为(6.78±2.14)分和(7.41±2.29)分,对照组分别为(11.38±2.94)分和(11.98±3.07)分,2组差异有统计学意义(P<0.01)。研究组癌症患者生命质量测定量表(EORTC QLQ-C30)中躯体功能、认知功能、社会功能、角色功能、情绪功能、总体健康状况评分均高于对照组,疲倦、疼痛、恶心呕吐、经济困难评分均低于对照组(P<0.05)。研究组恶心、呕吐、腮腺肿胀、颈部肿胀发生率低于对照组(P<0.05)。结论图文式临床护理路径应用于甲状腺癌术后大剂量^(131)I治疗中可明显缓解患者负性情绪,改善生活质量,降低并发症发生率。Objective To investigate the effect of graph-based clinical nursing pathway for postoperative thyroid cancer patients with high-dose iodine-131(131 I)treatment.Methods Totally 52 postoperative thyroid cancer patients with high-dose 131 I treatment between July,2015 and July,2016 were included as the control group.Another 52 patients with high-dose 131 I treatment between August 2016 and August,2017 were selected as the observation group.Patients in the control group were given routine nursing and health education,and those in the study group received graph-based clinical nursing pathway.The negative emotion of postoperative patients was evaluated by Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMA).The quality of life of patients was evaluated by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30).The incidence of complications was compared between two groups.Results Patients in the study group achieved lower scores of HAMA(6.78±2.14 vs.11.38±2.94,P<0.01)and HAMD(7.41±2.29 vs.11.98±3.07,P<0.01)compared with those in the control group after implementation of nursing interventions.Compared with those in the control group,patients in the study group had a better outcome in10 different domains of EORTC QLQ-C30,including physical function,cognitive function,social function,role function,emotional function,general health,fatigue,pain,nausea and vomiting,economic difficulties(P<0.05).The incidence of nausea,vomiting,parotid gland swelling and neck swelling was lower in the study group than that of controls(P<0.05).Conclusion The graph-based clinical nursing pathway is potentially effective to improve the mental status and quality of life in postoperative thyroid cancer patients with high-dose 131 I treatment.

关 键 词：临床护理路径 甲状腺癌 碘131 负性情绪 生活质量 并发症 

分 类 号：R817.5[医药卫生—影像医学与核医学]