不同护理模式在乳腺癌改良根治手术中的应用效果研究  

The nursing effects based on posture and thermal insulation as well as feedforward control during modified radical mastectomy

作　　者：杨雨 王少华[1] 路遥[1] 王蕾[1] YANG Yu;WANG Shaohua;LU Yao(Operating Room,Bozhou People’s Hospital,Anhui,Bozhou 236800,China)

机构地区：[1]安徽省亳州市人民医院手术室,236800

出　　处：《河北医药》2021年第13期2070-2073,共4页Hebei Medical Journal

基　　金：安徽省科技计划项目(编号:1704a0802170)。

摘　　要：目的探究乳腺癌改良根治手术中的体位和术中保温及基于前馈控制的护理效果。方法选择2017年10月至2019年10月收治的80例乳腺癌患者,按照随机数表法分为观察组和对照组,每组40例。2组均采用乳腺癌改良根治术治疗。对照组采用传统仰卧体位+常规保温+传统护理,观察组采用改进体位+复合保温+基于前馈护理。观察2组手术期间情况(手术时间、术中出血量、体温变化、术中无影灯调节次数);手术结束后,比较2组术后上肢皮肤压红、上肢被动外展>90°;比较2组医生操作舒适度以及患者满意率;住院1个月间比较2组手术部位感染发生率。结果观察组手术操作时间、术中出血量、无影灯调节次数、术后上肢皮肤压红、上肢被动外展>90°均低于对照组(P<0.05);2组在全麻前、全麻后30 min以及手术结束时的体温变化差异无统计学意义(P>0.05),观察组全麻后60 min、90 min体温均高于对照组(P<0.05);观察组医生舒适度及患者满意度高于对照组(P<0.05);观察组手术切口感染发生0例,对照组手术切口感染发生7例,观察组低于对照组(χ^(2)=7.671,P=0.005)。结论在乳腺癌改良根治术中采用改进体位有利于手术中医生便利性和舒适度,提高手术安全;复合保温有效预防患者低体温现象,降低术后并发症发生率,基于前馈控制理念下的护理干预能够促进患者术后预后恢复,提高护理满意度,值得推广应用。Objective To investigate the nursing effects based on posture and thermal insulation as well as feedforward control during modified radical mastectomy.Methods A total of 80 patients with breast cancer who were treated by modified radical mastectomy were enrolled in the study,who were randomly divided into observation group(improved posture+compound insulation+nursing based on feed-forward)and control group(traditional supine position+conventional insulation+traditional nursing measures),with 40 cases in each group.After operation the operation time,intraoperative blood loss,body temperature change,intraoperative shadowless lamp adjustment frequency,postoperative red skin pressure on the upper limbs,passive abduction of the upper limbs>90°,and the operation comfort degree and satisfaction rate of patients as well as the incidence rate of of surgical site infection were observed and compared between the two groups.Results The operation time,intraoperative blood loss,the frequency of shadowless lamp adjustment,postoperative red skin pressure on the upper limbs,and passive abduction of the upper limbs>90°in observation group were significantly lower than those in control group(P<0.05).There were no significant differences in the changes of body temperature before general anesthesia,at 30 minutes after general anesthesia and at end of operation between the two groups(P>0.05),however,the body temperature at 60min and 90min after general anesthesia in observation group were significantly higher than those in control group(P<0.05).Moreover the operation comfort degree and satisfaction rate of patients in observation group were significantly higher than those in control group(P<0.05).In addition the incidence rate of of surgical site infection in observation group was significantly lower than that in control group(P<0.05).Conclusion The improved posture in modified radical mastectomy is beneficial to the convenience and comfort of the doctor during operation,which can improve the safety of the operation,and reduce the i

关 键 词：前馈控制理念 乳腺癌 改良根治手术 手术体位 复合保温 

分 类 号：R473.6[医药卫生—护理学]