目的 探讨分阶段护理联合抗阻力训练在乳腺癌患者术后的应用效果.方法 选取2018年6月至2021年6月于郑州大学第一附属医院接受乳腺癌根治术治疗的162例乳腺癌患者.采用随机数表法将患者分为对照组和观察组,各81例.对照组患者接受常规护理联合抗阻力训练干预,观察组患者接受分阶段护理联合抗阻力训练干预,两组均干预12周.比较两组干预前、干预12周时上肢肿胀程度(上臂周径差、上肢体积差与上肢淋巴流量)、肩关节功能(采用中文版Constant-Murley肩功能评分量表评估)与中文版乳腺癌患者生命质量测定量表(FACT-B)评分.结果 干预12周,两组上臂周径差、上肢体积差均缩小,观察组上臂周径差、上肢体积差较对照组小(P<0.05);干预12周,两组上肢淋巴流量均升高,观察组上肢淋巴流量较对照组高(P<0.05).干预12周,两组肩关节功能评分、FACT-B评分高于干预前,观察组肩关节功能评分、FACT-B评分高于对照组(P<0.05).结论 分阶段护理联合抗阻力训练干预可减轻乳腺癌患者术后上肢肿胀程度,改善肩关节功能,提高生活质量.

Objective:To explore the nursing effect of early quantitative ambulation in patients undergoing radical mastectomy.Methods:A total of 109 cases of breast cancer patients who underwent radical mastectomy in the First Affiliated Hospital of Zhengzhou University from June to December 2019 were selected as the control group, while another 113 cases from January to June 2020 were selected as the observation group by convenience sampling method. The control group received routine activity nursing, and the observation group received early quantitative activity training. The activity volume, shoulder range of motion, compliance and complication rate of the two groups were compared.Results:The amount of activity in the observation group was higher than that in the control group, and the difference was statistically significant ( P<0.05) . The shoulder flexion, abduction, adduction and extension angles of the observation group at discharge and 12 weeks after discharge were greater than those of the control group, and the differences were statistically significant ( P<0.05) . The compliance rate of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The incidence of complications in the observation group at discharge and 12 weeks after discharge was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Quantitative ambulation training can increase the activity of patients with breast cancer, help to improve the range of motion of shoulder joint, reduce the incidence of complications, and improve the compliance of patients.

目的:探究配偶同步认知疗法对围术期乳腺癌患者焦虑抑郁心理状况及社会支持的影响.方法:选取2019年1月-2020年12月某院收治的乳腺癌患者100例,随机分为对照组(n=50)和观察组(n=50),对照组行常规干预,观察组行配偶同步认知疗法.比较两组干预前后焦虑抑郁心理[焦虑自评量表(SAS)和抑郁自量表(SDS)]、疾病不确定感[Mishe1制定的疾病不确定感量表(MUIS)]、社会支持[社会支持量表(SSRS)]及生活质量[生命质量核心问卷(EORTC QLQ-C30)量表].结果:干预后,与对照组相比,观察组SAS和SDS评分明显较低(t=-4.081,-3.449;P＜0.05);与对照组相比,观察组MUIS各维度评分及总分明显较低(t=-7.345,-12.015,-7.245,-4.605,-15.777;P＜0.05);与对照组相比,观察组SSRS各维度评分明显较高(t=3.061,7.469,7.541;P＜0.05);与对照组相比,观察组EORTC QLQ-C30各维度评分明显较低(t=-4.226,-7.800,-7.906;P＜0.05).结论:针对围术期乳腺癌患者实施配偶同步认知疗法可改善患者的不良情绪,降低疾病不确定感,促进了社会支持,提升患者生活质量.

Objective:To explore the effects of health education with the participation of spouses on medication compliance and self-management efficacy in breast cancer patients with endocrine therapy.Methods:From June 2018 to May 2019, we selected breast cancer patients with modified radical mastectomy in the First Affiliated Hospital of Zhengzhou University as research objects. According to the time of admission, patients were divided into two groups; 40 surgery patients hospitalized from June to November 2018 were in control group, and 36 surgery patients hospitalized from December 2018 to May 2019 were in experimental group. There were four cases lost in control group and two cases withdrew from experimental group for personal reasons. Finally, experimental group included 34 cases and control group included 36 cases. Control group provided routine discharge education at discharge and routine follow-up after discharge. On this basis, experimental group invited the spouses of patients to participate in health education. After 6 months of intervention, we compared the medication compliance and scores of Self-Management Efficacy Scale between two groups.Results:After 6 months of intervention, the medication compliance of control group and experimental group were (93.20±4.46) % and (98.60±3.12) % respectively with a statistical difference ( t=5.838, P<0.001) . After 6 months of intervention, dimension scores of society/family and compliance behavior, and total score of Self-Management Efficacy Scale in experimental group were higher than those in control group with statistical differences ( P<0.01) . After intervention, dimension scores of life/emotion and disease response in experimental group were higher than those in control group with no statistical difference ( P>0.05) . Conclusions:Health education with the participation of spouses can improve patients' social support and emotion, and improve the medication compliance and self-management efficacy of breast cancer patients with endocrine therapy, which has clinical promotion value.

目的 了解中青年乳腺癌患者手术方式决策困境现状及其影响因素,为针对性干预提供参考.方法 对198例住院拟行手术治疗的中青年乳腺癌患者,采用一般资料调查表、中文版决策困境量表和领悟社会支持量表进行问卷调查.结果 患者决策困境总分(43.59±15.68)分,多元逐步回归分析结果显示,领悟社会支持量表中的家庭支持和其他支持、家庭人均月收入、年龄、文化程度和对疾病知识了解程度是患者决策困境的主要影响因素(调整R2=0.783,P＜0.05,P＜0.01).结论 中青年乳腺癌患者手术方式决策困境程度较严重,宜从患者家庭及工作关系入手提高其社会支持水平,应特别重视年轻、文化程度较低、疾病知识不足等患者针对性决策信息的提供,从而降低决策困境.