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(Department of Interventional Radiology, the Second AffiliatedHospital of Harbin Medical University, Harbin 150086, China)



Application of Orem self-care theory on nursing for patients with hepatocellular carcinoma after transcatheter arterial chemoembolization

LIUYe,CAOSuyu,LIUYao,SHILin,LIYing*

(DepartmentofInterventionalRadiology,theSecondAffiliatedHospitalofHarbinMedicalUniversity,Harbin150086,China)

Objective To investigate the influence of the self-care theory on self-care and quality of life of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods A total of 120 patients with HCC from August 2013 to August 2015 were prospective analyzed. The randomization method was used to classified the patients into two groups: 60 patients in observation group were treated with self-care theory Orem care model, while 60 patients in control group were treated with conventional care model. Self-care and quality of life of two groups after TACE were observed and compared. Results Self-care score and the quality of life in observation group after TACE were significantly higher than that of control group (allP<0.05). Conclusion Orem self-care model theory can improve self-care and quality of life of patients with HCC after TACE.

Care theory; Chemoembolizaton, therapeutic; Liver neoplasms; Self-care; Quality of life

原发性肝细胞癌(hepatocellular carcinoma, HCC)是一种恶性程度较高、发展较快的临床常见恶性肿瘤,患者早期症状、体征均不明显，多数就诊时已为晚期，失去手术切除的机会[1]。随着现代医学的进步，肝动脉TACE已成为治疗中晚期原发性肝癌的首选方法。但化疗药物的使用可能产生一系列不良反应，如胃肠道反应、免疫力降低等躯体反应，同时也产生悲观、抑郁等心理反应。因此临床上应采用能够缓解患者躯体、心理症状，使患者了解相关知识，增强自信，提高患者自我护理能力、生存质量的护理模式[2]。Orem护理模式是由美国著名护理理论家Orem提出的一种基于自理理论的新型护理模式。本研究采用Orem自理理论中的护理模式对患者进行护理，成功提高患者自我护理能力及生存质量，现报道如下。

1 资料与方法

1.1一般资料 收集2013年8月—2015年8月收治的、接受肝动脉TACE治疗的HCC患者共120例，随机分为两组，每组60例，其中观察组住院期间采用Orem自理理论护理模式，男34例，女26例，年龄 49～76岁，平均(66.9±3.1)岁；对照组住院期间采用常规护理模式，其中男32例，女28例，年龄51～78岁，年龄(68.6±3.6)岁。两组患者性别、年龄等方面具有可比性。

1.2仪器与方法 采用Siemnes 1250mA DSA机作为介入治疗引导设备，以Seldinger穿刺将导管由股动脉选择性或超选择性插入肿瘤靶动脉，注入化疗药物(阿霉素25～35 mg、丝裂霉素15～20 mg、顺铂60～70 mg、5-氟尿嘧啶1.0～1.5 g)，流率2～3 ml/min，同时以碘化油栓塞肿瘤，使肝癌细胞无动脉血供应，最终坏死。

1.3常规护理模式 患者入院后，护士热情积极进行相关准备、介绍病区环境及责任护士，按肝癌疾病常规护理，认真做好TACE术前指导、术前准备及术后对症护理及心理护理等[3-4]。……