魏莉

摘 要 目的：探讨渐进式康复护理对改善乳腺癌根治术后生命质量的作用。方法：选取2012年11月—2014年1月乳腺癌患者97例，均行改良根治术治疗。将患者随机分为试验组49例和对照组48例。试验组患者于术后第1天进行第1节康复操训练，次日进行情况调查，并学习新的康复操。依次类推，直到患者出院。对照组患者进行常规护理，包括围术期护理、早期功能锻炼、出院指导等。采用健康相关生命质量量表（HRQOL）评估患者健康相关生命质量情况，包括5个维度。结果：干预前，试验组和对照组的HRQOL评分分别为（57.01±7.33）分和（57.18±8.44）分，组间差异无统计学意义（P>0.05）。干预后，试验组和对照组的HRQOL评分分别为（32.87±9.22）分和（37.81±6.44）分，均较治疗前改善（P<0.05），且试验组优于对照组（P<0.05）。干预后，两组患者的生理、与医务人员关系、心理社会、性功能、婚姻关系评分均低于干预前（P<0.05）；且试验组优于对照组（P<0.05）。结论：渐进式康复护理对改善乳腺癌改良根治术后患者生命质量有较好效果。

关键词 乳腺癌 康复护理 生命质量

中图分类号：R737.9 文献标识码：A 文章编号：1006-1533（2016）16-0060-03

Effect of progressive rehabilitation nursing on the quality of life of patients with breast cancer after radical mastectomy

WEI Li（Central Peoples Hospital of Jian City， Jiangxi Province 343000， China）

ABSTRACT Objective： To explore the effect of progressive rehabilitation nursing on the life quality of breast cancer patients after radical mastectomy. Methods： Ninety-seven cases of breast cancer that were all treated by modified radical mastectomy were selected from Nov. 2012 to Jan. 2014 and randomly divided into an experiment group with 49 cases and a control group with 48 cases. The experiment group was trained by the first section of rehabilitation exercise after operation for 1 day， the next day the condition was surveyed， and then the patients learned the new rehabilitation exercise in turn until the patients were discharged from the hospital. The control group was nursed by the routine nursing， including perioperative nursing， early function rehabilitation， discharge instruction and so on. The health-related quality of life scale （HRQOL） was used to assess the patients health-related quality of life. Results： Before intervention， the HRQOL in the experimental group and the control group were 57.01±7.33 and 57.18±8.44， respectively， and there were no significant differences between the two groups（P>0.05）. After intervention， the scores of the health related quality of life in the experimental group and the control group were 32.87±9.22 and 37.81±6.44， respectively， which were all improved compared with before treatment（P<0.05）， and the experiment group was better than the control group（P<0.05）. There were no significant differences in scores of the physiology， relationship with the medical staff， psycho-social factor， sexual function， and marriage relation of the patients in the two groups before intervention（P>0.05）. The scores of physiology， relationship with the medical staff， psycho-social factor， sexual function， and marriage relation for the experiment group were lower after intervention than before intervention in the two groups（P<0.05）. The intervention group was better than the control group（P<0.05）. Conclusion： Progressive rehabilitation nursing has the good clinical effect on the improvement of patients with breast cancer after modified radical mastectomy.

KEY WORDS breast cancer； rehabilitation nursing； quality of life

我国女性乳腺癌发病率相对较高，严重影响患者的生活质量，甚至危及生命[1]。乳腺癌患者行手术治疗往往会影响第二性征，而且化疗亦会影响患者的自我形象，使自尊心受到影响。因此，多数患者会在治疗期间出现心理问题，主要表现为焦虑、失眠、抑郁等[2-3]。对患者进行有效护理，对改善患者的心理状况具有重要意义。本文报道渐进式康复护理对改善乳腺癌改良根治术后患者生命质量的效果。

1 资料与方法

1.1 一般资料

选取2012年11月—2014年1月我院收治的乳腺癌患者97例，均行改良根治术并经病理证实。按照随机数字表法将患者分为试验组49例和对照组48例。试验组患者年龄22～69岁，平均（51.69±7.22）岁；浸润性导管癌40例，导管内癌8例，其他1例；组……