目的 分析快速康复外科(fast track surgery,FTS)理念在膀胱癌(bladder cancer,BC)患者根治性全膀胱切除术围术期护理中的应用效果.方法 回顾性收集我院147例BC患者,均接受根治性全膀胱切除术治疗,将2017年1月至2018年10月在围术期接受常规护理干预的73例作为对照组,将2020年10月至2021年10月在围术期接受FTS理念干预的74例作为观察组,比较两组围术期情况、不同时间点(术前1d及术后1 h、1 d)疼痛程度、并发症指标.结果 观察组术后首次下床活动时间、术后首次排气时间以及住院时间均短于对照组(P＜0.05);两组视觉模拟疼痛评分(visual analogue scale,VAS)比较,差异具有统计学意义(P＜0.05);观察组和对照组不同时间点的VAS评分比较,差异具有统计学意义(P＜0.05);两组VAS评分在时间和组间存在交互作用(P＜0.05);两组术后并发症率比较,观察组为31.08％(23/74),对照组为41.10％(30/73),组间比较差异无统计学意义(P＞0.05).结论 FTS理念护理应用于BC患者根治性全膀胱切除术围术期,能减轻疼痛程度,缩短术后首次下床活动、术后首次排气时间,促进术后恢复.

目的 探讨基于量化评估策略的延续性护理对前列腺癌根治术患者的影响.方法 选取2019年3月至2020年9月郑州大学附属肿瘤医院收治的75例接受前列腺癌根治术的患者作为对照组,接受常规延续性护理干预,选取2020年10月至2022年3月收治的75例接受前列腺癌根治术的患者作为观察组,接受基于量化评估策略的延续性护理干预.比较两组患者干预前后情绪状态、干预后控尿能力、康复指标、术后并发症发生率.结果 干预后两组患者SAS、SDS评分较干预前降低,观察组低于对照组(P<0.05);观察组控尿能力总有效率高于对照组(P<0.05);观察组首次下床、首次排气、首次进食及住院时间均短于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05).结论 基于量化评估策略的延续性护理能有效改善前列腺癌根治术患者的不良情绪,提高术后控尿能力,缩短康复时间,降低术后并发症发生率.

Objective:To assess the relationship between serum Netrin-1 and colorectal cancer (CRC) liver metastases, and the diagnostic value in CRC liver metastases in combination with carcinoembryonic antigen (CEA ).Methods:A total of 230 patients with CRC (175 patients without liver metastases and 55 with liver metastases, based on Dukes' staging system) were selected from October 2015 to October 2020. Serum Netrin-1 levels were measured using commercial ELISA kits. The statistical analyses included binary logistic regression and receiver operating characteristics (ROC )to evaluate prediction accuracy.Results:Serum Netrin-1 in CRC liver metastases patients was showed higher levels than those in CRC patients without liver metastases ( P < 0.001 ). After adjustment, serum levels of Netrin-1 were found association with the risk of CRC liver metastases (odd ratio 1.003, 95% CI: 1.001-1.005, P=0.001). To identify CRC liver metastases, the combination of serum CEA and Netrin-1 was showed better performance (area under ROC curve 0.748 , 95% CI: 0.669-0.826, sensitivity 0.582, specificity 0.846, accuracy 0.783 )than single markers ( P values both less than 0.05). Conclusions:Serum Netrin-1 is an independent risk factor of CRC liver metastases. Its combination with CEA shows fine identification performance, which offers insights to the screening and early diagnosis of CRC liver metastases.

Objective To explore the impact of PERMA nursing mode on feeling of well-being and mental state of patients with urostomy. Methods A total of 150 patients with bladder cancer resection and urostomy admitted to our hospital from October 2018 to October 2021 were selected and randomly divided into two groups, with 75 cases in each group. The control group received routine nursing,and the observation group received PERMA nursing. The mental state and feeling of well-being were compared between the two groups.Results After intervention, the SAS and SDS scores of the observation group were significantly lower than those of the control group, and the scores of each dimension of GWB were significantly higher than those of the control group（P ＜0.05）. Conclusions PERMA nursing mode can relieve anxiety and depression of patients with urostomy, and improve their subjective feeling of well-being.

目的 探讨肾肿瘤部分切除术患者应用同伴支持教育联合加速康复外科(ERAS)理念的护理效果.方法 选取郑州大学附属肿瘤医院收治的104例肾肿瘤部分切除术患者作为研究对象,依据随机数表法分成观察组和对照组,每组52例.2组患者均予以常规护理干预,对照组患者在常规护理基础上应用同伴支持教育,观察组患者在对照组护理措施基础上联合ERAS理念进行干预.观察干预前及干预3个月后2组患者社会支持、自我管理效能及健康促进生活方式评分变化,并比较2组患者围术期指标.结果 观察组患者首次肛门排气时间、首次下床活动时间及术后住院时间均显著低于对照组(t=5.511、11.476、6.596,P均＜0.001).干预3个月后,观察组和对照组患者社会支持评定量表评分中客观支持、主观支持、对支持利用度及总分均较干预前显著升高(观察组:t=9.569、7.704、9.316、13.269,P均＜0.001;对照组:t=4.774,P＜0.001;t=3.070,P=0.003;t=4.616,P＜0.001;t=5.916,P＜0.001),且观察组均显著高于对照组(t=4.234、4.212、5.299、6.953,P均＜0.001).干预3个月后,观察组和对照组患者中文版癌症自我管理效能感量表评分中正性态度、自我决策、缓解压力及总分均较干预前显著升高(观察组:t=9.885、8.546、12.385、17.178,P均＜0.001;对照组:t=5.691、4.880、8.405、10.364,P均＜0.001),且观察组均显著高于对照组(t=4.175,P＜0.001;t=3.385,P=0.001;t=4.473,P＜0.001;t=6.792,P＜0.001).干预3个月后,观察组和对照组患者健康促进生活方式量表-Ⅱ评分中自我实现、健康责任、运动休闲、适当营养、人际支持、压力处理评分及总分均较干预前显著升高(观察组:t=5.125、5.815、10.589、8.293、5.400、6.799、11.204,P均＜0.001;对照组:t=2.448,P=0.016;t=2.678,P=0.009;t=6.590,P＜0.001;t=4.143,P＜0.001;t=3.088,P=0.003;t=4.114,P＜0.001;t=5.828,P＜0.001),且观察组均显著高于对照组(t=2.954,P=0.004;t=3.163,P=0.002;t=5.064,P＜0.001;t=4.341,P＜0.001;t=2.587,P=0.011;t=2.497,P=0.014;t=5.502,P＜0.001).结论 同伴支持教育联合ERAS理念护理干预可显著加速肾肿瘤部分切除术患者术后恢复,提高其社会支持水平,帮助提高自我管理效能,利于患者健康行为形成,值得推广应用.

目的 分析不同放疗剂量对局部晚期食管癌患者疗效及血清肿瘤标志物的影响.方法 选取2014年1月～2017年12月同步放化疗的局部晚期食管癌患者59例,按放疗剂量的不同分为高剂量组(n=30)与常规剂量组(n=29).两组均予以同步周剂量化疗,多西他赛40 mg+奈达铂30 mg,每周1次,连用3周,在此基础上,常规剂量组采用常规剂量放疗,高剂量组采用高剂量放疗.对比两组近期疗效,对比治疗前及治疗后血清肿瘤标志物血小板应答蛋白1(TSP1)、血管内皮生长因子(VEGF)的水平、不良反应发生率和远期疗效(3年局部控制率、3年生存率).结果 高剂量组总有效率73.33％(22/30),与常规剂量组72.41％(21/29)对比,差异无统计学意义(P>0.05);两组患者血清TSP1、VEGF的水平在治疗前及治疗后组间对比差异无统计学意义(P>0.05);治疗后两组血清TSP1水平均较治疗前有所增高,VEGF水平均较治疗前有所降低(P<0.05);高剂量组的肠道性反应、放射性食管炎、骨髓抑制发生率分别为30.00％(9/30)、33.33％(10/30)、30.00％(9/30),与常规剂量组的27.59％(8/29)、31.03％(9/29)、27.59％(8/29)对比差异无统计学意义(P>0.05);高剂量组的3年局部控制率、3年生存率72.41％(21/29)、55.17％(16/29)较对照组的46.43％(13/28)、28.57％(8/28)高(P<0.05).结论 高剂量和常规剂量放疗在局部晚期食管癌患者中近期效果确切,均可下调血清肿瘤标志物,但高剂量放疗可提高远期效果,提高3年局部控制率和3年生存率,且未明显增加不良反应发生率.

Objective To study the changes of endotoxin in blood,Escherichia coli,lactobacillus,bifidobacterium,enterococci in feces of HCC patients.Methods Real-time fluorescence quantitative PCR was used to detect the difference between HCC group and normal group in the expression in bifidobacterium,lactobacillus,enterococcus and Escherichia coli,and the difference of endotoxin level.Results The expression levels of Escherichia coli and enterococcus in HCC group were significantly higher than those in normal control group (P＜ 0.05).Bifidobacterium and lactobacillus in primary liver cancer group significantly decreased compared with the normal group (P ＜ 0.05).The serum endotoxin level in HCC group was significantly higher than that in normal control group (P ＜ 0.05).Bifidobacterium and lactobacillus increased in HCC group.Enterococcus and escherichia coli decreased in HCC group.There was a significant positive correlation between endotoxin content and tumor number and tumor diameter in HCC patients.Conclusion Bifidobacterium,lactobacillus decreased,enterococcus and Escherichia coli increased in HCC patients.These changes along with the increase of endotoxin may relate to the development of HCC.

Objective To investigate the correlation between self-perceived burden (SPB) and cancer-related fatigue (CRF) in postoperative patients with bladder cancer surviving more than 5 years. Methods A total of 62 postoperative patients with bladder cancer surviving more than 5 years hospitalized in Urology Department of Affiliated Cancer Hospital of Zhengzhou University from January 2014 to December 2016 were selected using convenient sampling method. Patients were evaluated using Self-Perceived Burden Scale for Cancer Patients (SPBS-CP) and Brief Fatigue Inventory (BFI) . Results The total scores of SPBS-CP and BFI of 62 patients were (85.89±13.82) and (62.29±15.46) . Pearson correlation analysis showed that the total score of SPBS-CP positively correlated with the total BIF score (r=0.492, P<0.01) . Conclusions The CRF and SPB in postoperative patients with invasive bladder cancer surviving more than 5 years are at a severe level, and there is a positive correlation between them. Nursing workers should focus on the psychological counseling to relieve burden of patients and improve their quality of life. Key words: Urinary bladder neoplasms; Cancerous fatigue; Self-perceived burden

目的:探讨重组人血管内皮抑制素联合顺铂治疗肺癌胸腔积液的临床效果.方法:此次选择了2015年2月-2017年2月于我院诊治的肺癌胸腔积液患者60例作为研究对象,将患者根据其治疗方式分为:对照组单纯用顺铂治疗,观察组用重组人血管内皮抑制素+顺铂治疗;比较两组患者各项实验数据.结果:观察组临床治疗效果优于对照组,组间比较差异有统计学意义(P<0.05).结论:用重组人血管内皮抑制素+顺铂治疗肺癌胸腔积液者临床效果显著,值得临床上广泛用于治疗肺癌胸腔积液者.

Objective To study the value of specific measures of extended nursing service for bladder cancer patients who received excision operation under cystoscope. Methods A total of 66 bladder cancer patients who have re-ceived excision operation under cystoscope from February 2012 to February 2014 were chosen as the research objects. This research has got Ethics Committee's approval and gained the patients' and their relatives' informed-consent. The research objects were randomly individed into control group ( n=30 ) and experimental group ( n=36 ) according to the order of admission. The patients in control group received common nursing, and the patients in experimental group re-ceived extended nursing service. And the effect of nursing was compared. Results Postoperative complication rate of observation group in hospital was significantly lower than that of the control group, the time of hospital stay was signifi-cantly shorter, and nursing satisfaction was significantly improved, the differences had statistical significance ( P<0. 05). Anxiety and depression scores of the observation group were significantly lower than those of the control group, and the differences were statistically significant ( P<0. 05 ) . The follow-up visit outside the hospital to observation group showed that the compliance was significantly improved, life quality score got improved significantly, and the differences were statistically significant ( P<0. 05 ) . Conclusions Extended care services improve the effect of transurethral resec-tion with the help of bladder endoscope on patients and long-term prognosis from the two sides of content and scope, wor-thy of clinical application and promotion.

目的：探讨膀胱癌患者行腹腔镜下膀胱全切根治膀胱癌-回肠新膀胱术术后的并发症处理的护理措施及引流管使用的护理。方法将我院2012年～2013年收治的实施腹腔镜下膀胱全切根治膀胱癌-回肠新膀胱术的膀胱癌患者26例设为观察组，将我院2009年～2011年收治的实施腹腔镜下膀胱全切根治膀胱癌-回肠新膀胱术的膀胱癌患者26例设为对照组。对照组实施常规护理，观察组实施全方位护理。记录两组患者术后并发症发生情况及患者对护理工作的满意度。结果观察组患者并发症发生率为3.8％，显著低于对照组（19.2％）（P＜0.05），患者的护理质量均显著优于对照组（均P＜0.05），患者对护理工作的满意度为96.2％，显著高于对照组（76.9％）（P＜0.05）。结论对实施腹腔镜下膀胱全切根治膀胱癌-回肠新膀胱术的膀胱癌患者实施全方位的并发症和引流管护理可以有效的降低并发症发生率，提高护理质量和患者的满意度。