周芳　　吴莉莉　　蔡灵芝

[摘要] 目的 探討接受手术治疗的乳腺癌患者应用基于快速康复外科理念多模式护理干预的效果。 方法 选取2016年4月至2019年10月接受治疗的乳腺癌患者将118例，分为对照组（n=59）与试验组（n=59），两组患者均接受手术治疗，对照组应用传统护理干预模式，试验组应用基于快速康复外科理念的多模式护理模式，比较两组手术相关指标、术后6个月患肢肩关节功能恢复效果以及住院期间并发症情况。 结果 试验组总引流量少于对照组，引流管留置时间及住院时间均短于对照组，两组比较，差异有统计学意义（P<0.05）。试验组患肢功能优良率高于对照组，两组患肢功能恢复效果比较，差异有统计学意义（P<0.05）。试验组术后胸大肌萎缩、皮下积液等并发症发生率低于对照组，两组并发症发生率比较，差异有统计学意义（P<0.05）。入院时两组生存质量比较，差异无统计学意义（P<0.05）;试验组出院时、出院后3个月及出院后6个月生存质量均高于对照组，两组比较，差异有统计学意义（P<0.05）。 结论 采用手术治疗的乳腺癌患者围术期应用基于快速康复外科理念的多模式护理干预可提高护理质量，促进患者术后恢复。

[关键词] 快速康复外科理念;多模式护理干预;乳腺癌;手术指标;患肢功能恢复;术后并发症;生存质量

[中图分类号] R472          [文献标识码] B          [文章编号] 1673-9701（2021）11-0184-04

Application of multi-mode nursing intervention based on the concept of rapid rehabilitation surgery to the patients undergoing breast cancer operation

ZHOU Fang   WU Lili   CAI Lingzhi

Affiliated Hangzhou First People′s Hospital， Zhejiang University School of Medicine， Hangzhou   310006， China

[Abstract] Objective To explore the effect of multi-mode nursing intervention based on the concept of rapid rehabilitation surgery on the patients with breast cancer undergoing surgical treatment. Methods From April 2016 to October 2019，a total of 118 patients with breast cancer who received treatment were divided into the control group（n=59） and the experimental group（n=59）. Both groups received surgical treatment.The control group was treated with traditional mode of nursing intervention，while the experimental group was treated with multi-mode nursing intervention based on the concept of rapid rehabilitation surgery. The operation-related indexes， the recovery of shoulder joint function of affected limbs 6 m after operation and the complications during hospitalization were compared between the two groups. Results The total drainage volume of the experimental group was less than that of the control group，the indwelling time of the drainage tube and the hospitalization time were both shorter than those of the control group， and the differences in operation-related indexes between the two groups were statistically significant（P<0.05）. The excellent and good rate of the function of affected limb in the experimental group was higher than that in the control group， and the difference in the recovery of the function of affected limb between the two groups was statistically significant（P<0.05）. The incidence of postoperative complications such as pectoralis major atrophy and subcutaneous effusion， etc. in the experimental group was lower than that in the control group， and the difference in the incidence of complications between the two groups was statistically significant（P<0.05）. At admission， the difference in the quality of life（QoL） between the two groups was statistically insignificant（P>0.05）. The QoL of the experimental group at discharge， 3 m after discharge and 6 m after discharge was better than that of the control group， and the difference between the two groups was statistically significant（P<0.05）. Conclusion Multi-mode nursing intervention based on the concept of rapid rehabilitation surgery during the perioperative period of the patients with breast cancer undergoing surgical treatment can improve the nursing quality and promote the postoperative recovery of the patients.

[Key words] The concept of rapid rehabilitation surgery; Multi-mode nursing intervention; Breast cancer; Surgical indicators; Function recovery of affected limb; Postoperative complication; Quality of life

当前由于女性人群面临的生活压力与工作压力不断加大、生活方式与饮食结构不断发生变化、环境问题日益突出等，乳腺癌发病率不断升高，但是随着诊断及治疗技术的不断发展，患者5年生存率获得了明显的提高[1-2]。乳腺癌改良根治术配合术后辅助化疗等为临床主要治疗手段，能够有效消灭病灶，控制病情进展，提升患者生存品质。但是手术属于侵入性操作，患者同时承受着癌痛的折磨，容易加重其生理及心理不适感，对手术疗效以及患者术后恢复效果均会产生影响[3]。快速康复理念主要指围术期在循证医学基础上对各种处理措施进行优化并根据患者实际治疗和康复需求等重新整合并改进最新的护理医学技术以及护理方法，最大限度地减轻患者的应激反应，减少围术期相关并发症，加快患者康复[4-5]。……