系统护理对乳腺癌患者围手术期癌因性疲乏及生活质量的影响
[摘要] 目的 探讨系统护理对乳腺癌患者围手术期癌因性疲乏及生活质量的影响。 方法 选取自2013年1月～2015年1月在我院择期行乳腺癌根治术的乳腺癌患者100例。采取数字随机抽取法分为对照组和观察组，每组50例。对照组患者行常规护理，观察组患者行系统护理，包括术前护理、术后护理、饮食指导、运动锻炼指导、情志指导。比较护理前、后两组患者的癌因性疲乏程度、生活质量评分。 结果 与护理前相比，护理后两组患者的癌因性疲乏程度均明显减轻，差异有统计学意义（P<0.05），护理后观察组患者的癌因性疲乏程度较对照组明显更轻，差异有统计学意义（P<0.05）；两组护理后躯体功能、心理健康、社会功能、物质生活的评分及总分均显著高于护理前，差异有统计学意义（P<0.05）；观察组护理后生活质量评分均显著高于对照组护理后，差异有统计学意义（P<0.05）。 结论 在乳腺癌患者的围手术期给予患者系统护理，能够有效减轻患者的癌因性疲乏，提高患者的生活质量水平。
[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2016）09-0131-04
[Abstract] Objective To discuss the effects of systematic nursing on cancer-related fatigue and quality of life in perioperative patients with breast cancer. Methods A total of 100 patients who were given radical mastectomy due to breast cancer in our hospital from January 2013 to January 2015 were selected and randomly divided into the control group and the observation group， each with 50 patients. Patients in the control group were given routine nursing， while patients in the observation group were managed by systematic nursing， including preoperative nursing， postoperative nursing， diet guidance， exercise guidance， and emotion guidance. The degree of cancer-related fatigue and quality of life before and after nursing were compare between two groups. Results The degrees of cancer-related fatigue were significantly lower after nursing than before nursing in both groups（P<0.05）. The degree of cancer-related fatigue in the observation group after nursing was significantly lower than that in the control group（P<0.05）. The scores and total score of physical function， mental health， social function and material life were significantly higher after nursing than before nursing in both groups （P<0.05）. The scores of life quality in the observation group after nursing were significantly higher than those in the control group（P<0.05）. Conclusion Systematic nursing can effectively relieve cancer-related fatigue and improve the quality of life in perioperative patients with breast cancer.
[Key words] Breast cancer； Perioperative； Systematic nursing； Cancer-related fatigue； Quality of life
癌因性疲乏是指癌症患者因疾病本身、治疗方法、并发症等因素产生的主观性精神症状[1]。临床统计研究数据显示，癌因性疲乏在癌症患者中的发生率约为35%～75%[2]。该症持续时间长，对患者的生活质量具有极大的影响，成为癌症患者治疗后康复的主要影响因素之一。乳腺癌是威胁女性生命健康的重要恶性肿瘤之一，通常约90%的乳腺癌患者伴有癌因性疲乏，患者的身心健康受到严重影响[3]。寻找有效的护理方式以减轻乳腺癌癌因性疲乏症状成为临床广大妇科医师关注的焦点。黎秋霞等[4]研究表明，采用系统护理措施干预乳腺癌患者围手术期能有效改善其生活质量。故本研究对50例在我院行根治术的乳腺癌患者采用系统护理干预，并与常规护理方法进行对比分析，探讨系统护理干预对患者癌因性疲乏及生活质量的影响。现报道如下。 本次研究结果显示，两组护理后癌因性疲乏水平均显著降低，并且观察组患者癌因性疲乏水平降低程度显著优于对照组。两组护理后生活质量评分均显著提高，而观察组生活质量评分程度显著优于对照组。结果表明，常规护理方式能有效降低患者癌因性疲乏水平，提高患者生活质量，采用系统护理改善乳腺癌患者围手术期癌因性疲乏水平、提高生活质量的作用优于常规护理，此结果与国内一些相关研究结果相似[19，20]。
综上所述，系统护理能显著改善乳腺癌患者围手术期癌因性疲乏水平，显著提高患者的生活质量，有助于改善患者的预后。
