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循环护理对行尿道膀胱肿瘤电切术的膀胱癌患者心理状态及生活质量的影响
Effects of PDCA on psychological status and quality of life in patients with bladder cancer after transurethral resection of bladder tumor

刘晓敏 狄桂萍

Liu Xiaomin, Di Guiping

【摘要】目的 探讨循环护理对行尿道膀胱肿瘤电切术的膀胱癌患者术后心理状态及生活质量的 影响。方法 选取2013 年11 月—2015 年11 月北京陆军总医院收治的非肌层浸润性膀胱癌行尿道膀胱 肿瘤电切术患者95 例为研究对象,随机分为对照组(n=47)和观察组(n=48)。对照组采用常规护理,观 察组在常规护理的基础上采用循环护理模式,比较干预前后两组患者血清去甲肾上腺素(NE)、肾上腺 素(E)和皮质醇(Cor)水平的变化;采用SAS、SDS和自尊量表(SES)评定患者的心理状态;采用简明生活 质量量表(SF-36)评价患者的生活质量。结果 术后观察组患者血清NE、E 和Cor水平均低于对照组, 差异有统计学意义(P<0.01)。术后1个月观察组患者SAS和SDS评分低于对照组,SES评分高于对照组, 差异有统计学意义(P<0.01)。术后18个月,观察组患者SF-36评分高于对照组,差异有统计学意义(P< 0.01)。结论 循环护理模式可有效降低行TURBT的膀胱癌患者术后应激反应,改善其心理状态并提高 其生活质量,值得临床推广使用。
【摘要】Objective To investigate the effect of Plan-Do-Check-Action( PDCA) on postoperative psychological status and quality of life in patients with bladder cancer undergoing transurethral resection of bladder tumor( TURBT). Methods A total of 95 patients with non muscle invasive bladder cancer( NMIBC) undergoing TURBT hospitalized in Army General Hospital from November 2013 to November 2015 were selected and randomly divided into the control group( n=47) and the observation group( n=48). Patients in the control group received routine nursing care, while patients in the observation group received additional PDCA. The changes of serum norepinephrine( NE), epinephrine( E) and cortisol( Cor) levels were observed before and after the intervention in two groups. The SAS, SDS and the Self-esteem Scale( SES) were used to evaluate the psychological status of patients. The Simple Quality of Life Scale-36( SF-36) was applied to evaluate the quality of life of patients. Results The postoperative serum NE, E and Cor levels of patients in the observation group were significantly lower than those in the control group( P < 0.01). At 1 month after the operation, SAS and SDS scores of patients in the observation group were lower than those in the control group, while SES score in the observation group was higher than that of the control group; there were statistically significant differences between two groups( P < 0.01). At 18 months after the operation, SF-36 score of patients in the observation group was significantly higher than that of the control group( P< 0.01). Conclusions PDCA can effectively reduce the postoperative stress reaction of bladder cancer patients after TURBT and improve their psychological status and quality of life, which is worthy of clinical promotion.

【关键词】膀胱肿瘤; 生活质量; 循环护理; 经尿道膀胱肿瘤电切术; 心理状态
【关键词】Urinary bladder neoplasms; Quality of life; Plan-Do-Check-Action; Transurethral resection of bladder tumor; Psychological status