沐爱萍

【摘要】 目的：探讨人性化护理叙事医学模式应用于脑胶质瘤围术期患者对其身心康复影响结果。方法：选取2016年1月至2019年6月本院神经外科收治的脑胶质瘤患者44例，按照入院先后依次分为对照组和观察组各22例。对照组接受围术期常规护理，观察组在常规护理基础上实施基于叙事医学的人性化护理模式。干预4周后，比较两组患者心理状态（SAS、SDS、DAS）、生活质量及人文护理满意度。结果：干预后，观察组SAS、SDS、DAS评分均明显低于对照组;观察组生活质量评价条目中角色、躯体、认知、情绪和社会功能评分均明显高于对照组;出院调查，观察组人文护理满意度明显高于对照组;以上差异均有统计学意义（P<0.05）。结论：将人性化护理叙事医学模式应用于脑胶质瘤围术期患者，患者不良情绪状态明显缓解，生活质量和满意度明显提升，能较好地完成治疗和康复，显著改善预后。

【关键词】 脑胶质瘤;叙事医学;人性化护理;心理状态;生活质量;满意度

Effect of Humanized Nursing Based on Narrative Medicine on Physical and Psychological Rehabilitation of Patients with Glioma Perioperative Period

Mu Aiping

Department of Neurosurgery， the First Affiliated Hospital of Suzhou University， Suzhou，Jiangsu 215000

[Abstract] Objective：To explore the effect of humanized nursing narrative medicine model on the perioperative effects of human glioma perioperative period. Methods： Fortyfour patients with glioma admitted to our hospital from January 2016 to June 2019 were enrolled in the control group and 22 in the observation group. The control group received perioperative routine nursing， and the observation group implemented a narrativebased humanized nursing model based on routine nursing. After 4 weeks of intervention， the psychological status （SAS， SDS，DAS）， quality of life and human care satisfaction of the two groups were compared. Results： After intervention， the SAS， SDS， and DAS scores of the observation group were significantly lower than those of the control group; the role， physical， cognitive， emotional， and social function scores of the observation group were significantly higher than those of the control group; discharge survey， observation group humanities The satisfaction of nursing was significantly higher than that of the control group; the above differences were statistically significant （P<0.05）. Conclusion： The humanized nursing narrative medical model is applied to patients with glioma perioperative period. The patient's adverse emotional state is obviously relieved， and the quality of life and satisfaction are improved. It can better complete the treatment and rehabilitation and significantly improve the prognosis.

[Key words]Glioma; Narrative medicine; Humanized nursing; Psychological state; Quality of life; Satisfaction

脑胶质瘤是由于大脑和脊髓胶质细胞癌变所产生的，属于发病率较高的最常见的原发性颅脑肿瘤，约占40.49%[1]。脑胶质瘤按肿瘤细胞的形态学划分可分为星型细胞瘤、少枝细胞瘤、混合胶质瘤和室管膜瘤，按肿瘤细胞的恶性程度划分为低级别胶质瘤（WHO 1～2级）和高级别胶质瘤（WHO 3～4级）。临床较多见的高级别胶质瘤为低分化胶质瘤，属于恶性肿瘤，患者生存、预后较差[2]。脑胶质瘤临床表现为不同程度的癫痫和运动障碍等，手术治疗是目前该病症的主要治疗方式。虽然临床治疗效果显著，但胶质瘤很难根治，往往会复发，术后需要配合放化疗治疗，患者往往心理负担很重，严重影响生活质量[3]。因此，对围术期脑胶质瘤患者实施辅助性身心全方位人性化护理干预措施，对于改善患者的心理状态，使其积极配合治疗起主导作用，可有效提升患者身心康复效果[4]。……