预见性护理对膀胱全切输尿管皮肤造口患者术后并发症及生活质量的影响  

The impact of predictive nursing on the postoperative complications and quality of life in patient experienced radical cystectomy and cutaneous ureterostomy

作　　者：黄微星 万玲君 黄幻 章贝贝[1] HUANG Weixing;WAN Lingjun;HUANG Huan;ZHANG Beibei(Department of General Surgery,Taizhou Hospital Affiliated to Zhejiang University,Taizhou,Zhejiang,317000)

机构地区：[1]浙江大学台州医院综合外科,浙江台州317000

出　　处：《中西医结合护理》2022年第12期279-284,共6页Chinese Journal of Integrative Nursing

摘　　要：目的观察预见性护理对接受膀胱全切输尿管皮肤造口手术患者术后并发症及生活质量的影响。方法采用前瞻性研究,选取2018年3月—2021年5月浙江省台州医院泌尿外科收治的肌层浸润性膀胱癌患者为研究对象,根据随机数表法将患者分为两组,各36例,排除术后失访等因素,最终纳入63例进行分析。其中29例患者在围手术期接受常规护理,设为对照组;另34例患者给予预见性护理,设为干预组。观察两组患者术后并发症发生率,采用医学应对方式问卷(MCMQ)评估患者造口后的应对方式、自我护理能力量表(ES⁃CA)评估患者的自我护理能力、健康调查简表(SF-36)评估患者的生存质量。结果术后6个月时,干预组并发症总发生率14.71%(5/34),低于对照组的48.28%(14/29),差异有统计学意义(P<0.01);干预组患者MC⁃MQ问卷面对量表评分高于对照组(P<0.01);干预组患者ESCA量表的健康知识水平、自我护理技能、自护责任感评分高于对照组(P<0.05);干预组患者SF-36量表各维度得分均较对照组升高,差异有统计学意义(P<0.05)。结论对接受膀胱全切输尿管皮肤造口术患者围手术期进行预见性护理,可有效降低并发症发生,更能使患者积极应对术后造口生活,提升其自我护理能力及术后生存质量。Objective To explore the impact of predictive nursing on the postoperative com⁃plications and quality of life of inpatients experienced radical cystectomy and cutaneous ureterosto⁃my.Methods Patients with muscle-invasive bladder cancer admitted to the Department of Urolo⁃gy,Taizhou Hospital affiliated to Zhejiang University from March 2018 to May 2021 were select⁃ed as the research objects.According to the random number table method,the patients were divid⁃ed into two groups,with 36 cases in each group.Factors such as postoperative loss to follow-up were excluded,29 patients received routine nursing during the perioperative period,which was the control group.Another 34 patients received predictive nursing care,as the intervention group.Medical Coping Style Questionnaire(MCMQ)was used to evaluate patients'coping style after stoma,self-care ability Scale(ESCA)was used to evaluate patients'self-care ability,and Health Survey Short Form(SF-36)was used to evaluate patients'quality of life.Results The overall in⁃cidence of complications in the intervention group was lower than that in the control group at 6 months after surgery(14.71%vs.48.28%,P<0.01).Patients in the intervention group achieved higher a score of facing coping style in ESCA compared with that in the control group(P<0.01).Factor scores of health knowledge level,self-care ability and sense of self-care in the intervention group were higher than those in the control group(P<0.05).The factor scores of SF-36 in the intervention group were higher than those in the control group(P<0.05).Conclusion Perioperative predictive nursing for patients undergoing radical cystectomy and cutaneous ureteros⁃tomy can effectively reduce the occurrence of complications,make patients actively cope with postoperative life,and improve their self-care ability and quality of life.

关 键 词：预见性护理 根治性膀胱全切术 肌层浸润性膀胱癌 输尿管皮肤造口术 

分 类 号：R473.6[医药卫生—护理学]