伊纪瑛 唐晨曦 章淑芳 陈政儒 李佳丽 夏金蓉 李思宇 冷政伟

[摘要] 目的 探讨优质护理模式在晚期肝癌大量腹水患者中的临床效果。 方法 回顾性分析2014年1月～2017年6月南充市中心医院收治的92例晚期肝癌伴大量腹水患者，根据患者护理模式，将患者分为对照组和观察组，每组各46例。对照组为常规护理模式，观察组采用优质护理模式。观察两组患者的生活质量、疼痛、满意度评分的情况。 结果 护理后，观察组患者生活质量评分、满意度评分均高于对照组，差异有统计学意义（P < 0.05），数字化疼痛评分明显低于对照组，差异有统计学意义（P < 0.05）。 结论 对晚期肝癌伴大量腹水患者实行优质护理可显著改善患者的生活质量，降低患者的疼痛感，提高满意度，效果显著。

[关键词] 优质护理；晚期肝癌；腹水；疗效

[中图分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0161-04

[Abstract] Objective To explore the clinical effect of high-quality nursing care in advanced hepatocellular carcinoma patients with massive ascites. Methods From January 2015 to June 2017， in Nanchong Central Hospital， 92 patients with advanced hepatocellular carcinoma with massive ascites were selected， according to nursing method， they were divided into control group and observation group， with 46 cases in each group. The observation group was given high-quanlity nursing care， the control group was given conventional nursing care. The score of quanlity of life， pain and satisfaction degree for nursing were observed. Results After nursing， the scores of quanlity of life， satisfaction degree in observation group were higher than control group， the differences were statistically significant （P < 0.05）， scores of numeric rating scale in observation group was lower than control group， the difference was statistically significant （P < 0.05）. Conclusion Advanced hepatocellular carcinoma patients with massive ascites nursed with high-quanlity nursing care can improve quanlity of life， reduce pain， improve satisfaction degree， the clinical effect is remarkble.

[Key words] High quanlity-nursing care； Advanced hepatocellular carcinoma； Ascites； Clinical effect

數据显示，肿瘤性疾病在世界范围内的发病率呈逐渐上升的趋势，而肝细胞癌（hepatocellular carcinoma，HCC）在我国的发病率更是位居全球第一[1]。我国是一个发展中国家，国民体检意识欠缺，导致多数肿瘤不能早期发现，而大多晚期肿瘤的治疗效果差。且患者伴随晚期肿瘤疼痛，生活质量差，降低对生活期待。我国的HCC患者大多患有乙肝肝硬化，此类患者在晚期HCC时多伴有肝功能失代偿，继发腹水、下肢水肿、肝性脑病等，导致患者生活质量极低，长期存在焦虑、抑郁等负面情绪[2]；而优质护理模式的核心理念就是将“以患者为中心”的护理理念和人文关怀融入到对患者的护理服务中，为患者提供个性化护理服务[3-4]。目前优质护理在临床上已经得到广泛应用，但是如何针对不同患者进行个体化的特色优质护理仍值得进一步研究，本文将对优质护理模式在晚期HCC大量腹水患者中的应用效果做一报道。……