Abstract:

Objective　To observe the effects of perioperative predictive nursing on self-care ability, adverse emotions, and complications in patients with liver cancer undergoing radiofrequency ablation. Methods　A total of 92 patients with liver cancer who underwent radiofrequency ablation in Henan Provincial Hospital of Traditional Chinese Medicine from January 2021 to August 2022 were collected. They were randomly divided into 2 groups according to different nursing methods. In the control group, 46 patients [32 males and 14 females, aged (52.71±5.68) years] received routine nursing during the perioperative period. In the observation group, 46 patients [30 males and 16 females, aged (52.68±5.72) years] received predictive nursing on the basis of routine nursing during the perioperative period. The self-care ability (health knowledge mastery, self-care ability, self-care responsibility, and self-concept) and scores of Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were observed before and after nursing. The first anal exhaust time, bowel sound recovery time, first defecation time, pain intensity 6 h, 12 h, 24 h, and 48 h after surgery, postoperative complications were compared. t test was used for the measurement data, and χ² test was used for the count data. Results　The scores of health knowledge mastery, self-care ability, self-care responsibility, and self-concept in the observation group after nursing were (56.26±6.75) points, (39.15±4.31) points, (22.64±3.62) points, and (25.69±4.19) points, respectively, which were higher than those in the control group [(50.42±6.03) points, (32.19±4.02) points, (18.62±3.45) points, and (22.61±4.05) points], with statistically significant differences between the two groups (t=-4.736, -5.643, -4.183, and -6.582; all P<0.001). The SDS and SAS scores of the observation group after nursing were (39.42±4.21) points and (34.62±3.71) points, respectively, which were lower than those of the control group [(45.26±5.23) points and (40.29±4.65) points], with statistically significant differences between the two groups (t=5.899 and 6.465; both P<0.001). The first anal exhaust time, bowel sound recovery time, and first defecation time in the observation group after nursing were (21.54±2.03) h, (31.28±2.76) h, and (28.19±2.18) h, respectively, which were shorter than those in the control group [(28.36±2.25) h, (46.26±3.15) h, and (37.71±2.64) h], with statistically significant differences between the two groups (t=15.826, 17.526, and 14.625; all P<0.001). The Visual Analogue Scale (VAS) scores of the observation group 6 h, 12 h, 24 h, and 48 h after surgery were (7.05±0.49) points, (5.18±0.43) points, (4.19±0.39) points, and (3.52±0.34) points, respectively, which were lower than those of the control group [(7.56±0.51) points, (6.85±0.48) points, (4.96±0.41) points, and (4.05±0.39) points], with statistically significant differences between the two groups (t=4.891, 9.182, 6.426, and 13.462; all P<0.001). The incidence of postoperative complications in the observation group was 13.0% (6/46), which was lower than that in the control group [54.3% (25/46)] (χ²=17.563, P<0.001). Conclusion　Perioperative predictive nursing can improve the self-care ability in patients with liver cancer after radiofrequency ablation, reduce their depression, anxiety, and pain, and reduce the occurrence of complications.

Key words:

Liver cancer, Radiofrequency ablation, Self-care ability, Adverse emotions, Complications, Perioperative period, Predictive care

摘要：

目的　观察围术期预见性护理对肝癌射频消融术患者自我护理能力、不良情绪及并发症的影响。方法　收集2021年1月至2022年8月在河南省中医院行射频消融术的肝癌患者92例，按护理方式不同随机平均分为两组。对照组46例，男32例，女14例，年龄（52.71±5.68）岁，采用围术期常规护理；观察组46例，男30例，女16例，年龄（52.68±5.72）岁，在围术期常规护理基础上采用围术期预见性护理。观察护理前后患者自我护理能力（健康知识掌握、自护能力、自护责任感、自我概念），抑郁自评量表（SDS）、焦虑自评量表（SAS）评分。比较患者术后肛门首次排气时间、肠鸣音恢复时间和首次排便时间，术后6 h、12 h、24 h、48 h患者疼痛强度，术后并发症。计量资料采用t检验，计数资料采用χ²检验。结果　观察组护理后健康知识掌握、自护技能、自护责任感、自我概念评分分别为（56.26±6.75）分、（39.15±4.31）分、（22.64±3.62）分、（25.69±4.19）分，均高于同期对照组［（50.42±6.03）分、（32.19±4.02）分、（18.62±3.45）分、（22.61±4.05）分］，两组比较差异均有统计学意义（t=-4.736、-5.643、-4.183、-6.582，均P<0.001）。观察组护理后SDS和SAS评分分别为（39.42±4.21）分、（34.62±3.71）分，均低于同期对照组［（45.26±5.23）分、（40.29±4.65）分］，两组比较差异均有统计学意义（t=5.899、6.465，均P<0.001）。观察组护理后肛门首次排气时间、肠鸣音恢复时间和首次排便时间分别为（21.54±2.03）h、（31.28±2.76）h、（28.19±2.18）h，均短于同期对照组［（28.36±2.25）h、（46.26±3.15）h、（37.71±2.64）h］，两组比较差异均有统计学意义（t=15.826、17.526、14.625，均P<0.001）。观察组术后6 h、12 h、24 h、48 h视觉模拟评分量表（VAS）评分分别为（7.05±0.49）分、（5.18±0.43）分、（4.19±0.39）分、（3.52±0.34）分，均低于同期对照组［（7.56±0.51）分、（6.85±0.48）分、（4.96±0.41）分、（4.05±0.39）分］，两组比较差异均有统计学意义（t=4.891、9.182、6.426、13.462，均P<0.001）。观察组术后并发症发生率13.0%（6/46），低于对照组的54.3%（25/46）（χ²=17.563，P<0.001）。结论　围术期预见性护理可提高肝癌患者射频消融术后的自我护理能力，减轻患者抑郁焦虑和疼痛，降低并发症的发生率。

关键词:

肝癌, 射频消融术, 自我护理能力, 不良情绪, 并发症, 围术期, 预见性护理