循证护理干预应用在乳腺癌保乳手术围手术期预防并发症的效果

邹滢 孙婷婷 周太容 冯维恩

【摘要】 目的：观察循证护理干预应用在乳腺癌保乳手术围手术期预防并发症的效果。方法：将在笔者所在医院近年（2016年5月-2019年5月）收治的以乳腺癌为诊断拟行保乳手术患者60例，依据患者入院顺序分为两组。先入院的30例患者采用常规护理干预，设为对照组，后入院的30例患者采用循证护理干预，设为研究组。比较两组护理前后负性情绪评分、围手术期并发症发生情况及护理满意度。结果：护理后两组患者SAS、SDS评分均明显降低，且循证组明显低于对照组，差异有统计学意义（P<0.05）。循证组患者围手术期并发症发生率为3.33%，明显低于对照组的20.00%，差异有统计学意义（P<0.05）。循证组护理总满意度为100%，明显高于对照组的83.33%，差异有统计学意义（P<0.05）。结论：在乳腺癌保乳手术患者的护理中采取循证护理干预，可明显降低患者负性情绪，明显减少术后并发症的发生，提高护理满意度，效果理想。

【关键词】 循证护理 乳腺癌保乳手术 围手术期 并发症预防

[Abstract] Objective： To observe the effect of evidence-based nursing intervention in preventing complications in perioperative period of breast conserving surgery for breast cancer. Method： A total of 60 breast conserving surgery patients with breast cancer were treated in our hospital in recent years （from May 2016 to May 2019） were divided into two groups according to the order of admission. The first 30 patients were treated with routine nursing intervention， which was set as the control group， and the second 30 patients were treated with evidence-based nursing intervention， which was set as the study group. Negative emotional scores before and after nursing， perioperative complications and nursing satisfaction were compared between the two groups. Result： After nursing， SAS and SDS scores of patients in both groups were significantly reduced， and the evidence-based group was significantly lower the control group， the differences were statistically significant （P<0.05）. The perioperative complication rate of the evidence-based group was 3.33%， which was significantly lower than 20.00% of the control group， and the difference was statistically significant （P<0.05）. The total nursing satisfaction in the evidence-based group was 100%， which was significantly higher than 83.33% in the control group， and the difference was statistically significant （P<0.05）. Conclusion： Evidence-based nursing intervention in the nursing of breast cancer patients with breast conserving surgery， can significantly reduce the negative emotions of patients， significantly reduce the occurrence of postoperative complications， improve the nursing satisfaction， the effect is ideal.

乳腺癌屬于常见疾病，是女性最常见的发生在乳腺上皮组织的恶性肿瘤，在女性恶性肿瘤疾病死亡中高居首位，严重威胁着患者的身体健康甚至危及其生命[1]。随着筛查工作的不断深入开展，早期患病比例增加，随着医疗水平的不断进步，乳腺癌手术中的保乳手术已经获得了临床对其疗效的广泛认可[2]。而在围手术期间，患者因对疾病的恐惧、手术的负性情绪，增加了围手术期并发症的发生，增加了患者的痛苦[3]。常规护理干预多针对疾病本身，对患者个体较少进行过多的干预。而本研究运用循证护理，将针对可能出现并发症的一系列问题进行循证，获取最佳研究证据，进而提供更好的护理。

1 资料与方法

1.1 一般资料

将在笔者所在医院近年（2016年5月-2019年5月）收治的以乳腺癌为诊断拟行保乳手术的60例患者作为研究对象，纳入标准：经术后病理诊断符合乳腺癌标准;临床资料完整;依从性良好[4]。排除标准：广泛转移;合并其他系统疾病;曾接受过类似护理干预;精神异常;沟通、认知障碍者[5]。依据患者入院顺序将其分为两组，先入院的30例患者采用常规护理干预，设为对照组，后入院的30例患者采用循证护理干预，设为研究组。对照组患病时间1.2～16.8个月，平均（5.8±0.6）个月;年龄34～68岁，平均（47.3±4.1）岁;12例浸润性导管癌，9例浸润性小叶癌，8例黏液腺癌，1例硬癌。循证组患病时间1.1～17.2个月，平均（6.1±0.7）个月;年龄31～69岁，平均（46.8±4.3）岁;12例浸润性导管癌，8例浸润性小叶癌，9例黏液腺癌，1例硬癌。两组一般资料比较，差异无统计学意义（P>0.05），有可比性。患者均对本研究知情同意，本研究经医学伦理委员会批准实施。