张翱 姜琳莉 胡志琴 易珍

【摘要】 目的：探讨以赋能授权为导向的全方位护理模式在肝癌患者肝动脉化疗栓塞（TACE）介入治疗中的应用价值。方法：选取2021年3月—2022年3月在江西省肿瘤医院接受TACE介入治疗的100例肝癌患者进行研究，经随机数字表法分为两组。对照组（n=50）应用围手术期常规护理，观察组（n=50）在对照组基础上应用以赋能授权为导向的全方位护理模式。比较两组疾病不确定感[（Mishel疾病不确定感量表（MUIS）]、术后疼痛程度[视觉模拟评分法（VAS）]、术后恢复情况及并发症发生率。结果：护理后两组MUIS各维度评分均下降，且观察组均低于对照组（P<0.05）。观察组术后不同时间VAS评分均低于对照组（P<0.05）。观察组进食时间、排气时间、下床活动时间及住院时间均短于对照组（P<0.05）。观察组术后并发症发生率低于对照组（P<0.05）。結论：在肝癌患者TACE介入术治疗中实施以赋能授权为导向的全方位护理模式，可减轻患者疾病不确定感，降低术后疼痛程度及并发症发生率，促进术后恢复。

【关键词】 肝癌 肝动脉化疗栓塞 赋能授权 全方位护理模式 疾病不确定感

Application of Empowerment-oriented All-round Nursing Model in TACE Interventional Therapy for Patients with Liver Cancer/ZHANG Ao， JIANG Linli， HU Zhiqin， YI Zhen. //Medical Innovation of China， 2024， 21（08）： 0-102

[Abstract] Objective： To explore the application value of empowerment-oriented all-round nursing model in transcatheter arterial chemoembolization （TACE） interventional therapy for patients with liver cancer. Method： A total of 100 patients with liver cancer who received TACE interventional therapy in Jiangxi Cancer Hospital from March 2021 to March 2022 were selected for this study and divided into two groups according to random number table method. The control group （n=50） was treated with erioperative period routine nursing， and the observation group （n=50） applied the empowerment-oriented all-round nursing model based on the control group. Uncertainty in illness [Mishel uncertainty in illness scale （MUIS）]， postoperative pain degree [visual analogue scale （VAS）]， postoperative recovery and complication rate were compared between the two groups. Result： After nursing， the scores of MUIS in all dimensions decreased in both groups， and those in the observation group were lower than those in the control group （P<0.05）. The VAS scores of the observation group were lower than those of the control group at different time after operation （P<0.05）. The feeding， exhaust， getting out of bed and hospitalization time in the observation group were shorter than those in the control group （P<0.05）. The incidence of postoperative complications in observation group was lower than that in control group （P<0.05）. Conclusion： Implementing a empowerment-oriented all-round nursing model in TACE intervention therapy for liver cancer patients can reduce patients' uncertainty in illness， reduce postoperative pain and complications， and promote postoperative recovery.

[Key words] Liver cancer Transcatheter arterial chemoembolization Empowerment All-round nursing model Uncertainty in illness

First-author's address： Department of Medical Imaging， Jiangxi Cancer Hospital， Nanchang 330029， China

doi：10.3969/j.issn.1674-4985.2024.08.022

肝癌是发病率及死亡率均较高的恶性肿瘤之一，据统计，肝癌占全球癌症死亡的8.30%，而我国每年超过10万人因肝癌死亡，尽管近年来肝癌的手术方法及化疗药物不断更新，但多数患者预后表现仍不容乐观[1-2]。肝动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）介入治疗的效果已得到多方认可，目前已成为无开腹手术指征肝癌患者的常用方案，但由于中晚期肝癌患者癌细胞病灶血供丰富，介入治疗无法全面清除，部分患者术后不仅存在并发症还易复发，都将加重患者疾病不确定感，导致预后受到不利影响[3]。在肝癌介入治疗患者围手术期实施的常规护理，主要根据现有的护理流程与方案提供指导，内容较为单一且缺乏个性化。以赋能授权为导向的全方位护理模式是护理人员在明确护理职责的基础上为患者提供全面且优质的护理服务，并结合临床理论与实践为一体，在改善患者身心状态上充分发挥应有的作用[4]。……