Efficiency-oriented comprehensive nursing mode for patients undergoing radical prostatectomy

doi:10.3760/cma.j.issn.1007-1245.2024.09.036

Abstract

Abstract:

Objective　To explore the effects of an efficiency-oriented comprehensive nursing mode on the complication rate and physiological function in patients undergoing radical prostatectomy. Methods　From March 2021 to March 2022, 126 patients who underwent radical prostatectomy for prostate cancer at Wuxi Second People's Hospital were selected for the randomized controlled trial. They were divided into a control group and an observation group by the random number table method, with 63 cases in each group. The control group were (52.34±4.47) years old; their disease course was (8.56±3.46) months. The observation group were (50.78±5.25) years old; their disease course was (8.14±3.62) months. The control group used the conventional care model, and the observation group adopted efficiency-oriented comprehensive nursing mode. The recovery indicators, incidences of complications, physiological functions [the International Index of Erectile Function-5 (IIEF-5) was used to evaluated their erectile function before and 1 and 3 months after the surgery], and quality of life, evaluated by the MOS Item Short from Health Survey (SF-36), were compared the two groups. t and χ² tests were used. Results　After the nursing, the time for first flatus, time for first meal, time for the first time to get off bed, and hospitalization time in the observation group were significantly shorter than those in the control group [(22.87±4.62) d vs. (37.58±4.24) d, (4.65±1.68) d vs. (6.88±1.03) d, (2.53±1.09) d vs. (5.36±1.23) d, and (8.65±2.15) d vs. (15.78±2.68) d], with statistical differences (t=18.619, 8.982, 13.668, and 16.471; all P<0.05). The incidence of complications in the observation group was lower than that in the control group [6.35% (4/63) vs. 25.40% (16/63)], with a statistical difference (χ²=8.558; P=0.003). One and three months after the surgery, the scores of IIEF-5 in the observation group were higher than those in the control group [(13.14±3.68) vs. (9.98±4.25) and (18.22±4.31) vs. (11.54±3.93)], with statistical differences (t=4.461 and 9.090; both P<0.05). Before the nursing, there were no statistical differences in the scores of physical function, emotional role, social function, psychological health, body role, general health, body pain, and activity between the two groups (all P>0.05). After the nursing, the scores of physical function, emotional role, social function, psychological health, body role, general health, body pain, and activity in the observation group were higher than those in the control group [(61.67±10.36) vs. (55.98±11.68), (73.24±12.38) vs. (66.20±14.36), (67.29±16.46) vs. (61.01±12.23), (79.13±9.41) vs. (72.01±9.10), (66.85±13.15) vs. (59.42±15.48), (63.78±11.42) vs. (57.21±9.16), (73.45±11.40) vs. (63.21±15.46), and (81.97±12.46) vs. (74.43±14.14)], with statistical differences (t=2.639, 2.947, 2.431, 4.317, 2.903, 3.562, 4.231, and 3.100; all P<0.05). Conclusion　Efficiency-oriented comprehensive nursing mode for patients undergoing radical prostatectomy can shorten their recovery period, decrease the incidence of complications, and improve their postoperative erectile function and quality of life.

Key words:

Prostate cancer, Comprehensive nursing mode, Efficiency-oriented healthcare, Complications, Physiological functions

摘要：

目的　探讨效率医疗背景下的全程护理模式对前列腺癌根治术患者并发症和生理功能的影响。方法　开展前瞻性随机对照试验。选取2021年3月至2022年3月于无锡市第二人民医院接受前列腺癌根治术的126例患者作为研究对象，按照随机数字表法分为两组，各63例。对照组年龄（52.34±4.47）岁，病程（8.56±3.46）个月，采用常规护理模式；观察组年龄（50.78±5.25）岁，病程（8.14±3.62）个月，采用以效率医疗为背景的全程护理模式。对比两组患者康复指标、并发症发生率、生理功能［采用国际勃起功能问卷表-5（IIEF-5）对患者术前、术后1个月及3个月勃起功能进行评估］及护理前后生活质量［采用健康调查量表36（SF-36）评估］。统计学方法采用t检验、χ²检验。结果　观察组首次排气时间、首次进食时间、首次下床时间以及住院时间均短于对照组［（22.87±4.62）d比（37.58±4.24）d、（4.65±1.68）d比（6.88±1.03）d、（2.53±1.09）d比（5.36±1.23）d、（8.65±2.15）d比（15.78±2.68）d］，差异均有统计学意义（t=18.619、8.982、13.668、16.471，均P<0.05）。观察组并发症发生率为6.35%（4/63），低于对照组的25.40%（16/63），差异有统计学意义（χ²=8.558，P=0.003）。术前，两组患者IIEF-5评分比较，差异无统计学意义（P>0.05）；术后1个月、3个月，观察组IIEF-5评分均高于对照组［（13.14±3.68）分比（9.98±4.25）分、（18.22±4.31）分比（11.54±3.93）分］，差异均有统计学意义（t=4.461、9.090，均P<0.05）。护理前，两组患者身体功能、情感角色、社会功能、心理健康、身体角色、一般健康、身体疼痛、活力评分比较，差异均无统计学意义（均P>0.05）；护理后，观察组身体功能、情感角色、社会功能、心理健康、身体角色、一般健康、身体疼痛、活力评分均高于对照组［（61.67±10.36）分比（55.98±11.68）分、（73.24±12.38）分比（66.20±14.36）分、（67.29±16.46）分比（61.01±12.23）分、（79.13±9.41）分比（72.01±9.10）分、（66.85±13.15）分比（59.42±15.48）分、（63.78±11.42）分比（57.21±9.16）分、（73.45±11.40）分比（63.21±15.46）分、（81.97±12.46）分比（74.43±14.14）分］，差异均有统计学意义（t=2.639、2.947、2.431、4.317、2.903、3.562、4.231、3.100，均P<0.05）。结论　采用以效率医疗为背景的全程护理模式，前列腺癌根治术患者恢复期缩短，并发症发生率减少，术后勃起功能有所改善，同时提高患者生活质量。

关键词:

前列腺癌, 全程护理模式, 效率医疗, 并发症, 生理功能

Jin Helian, Feng Ninghan, Guo Yuehong.

Efficiency-oriented comprehensive nursing mode for patients undergoing radical prostatectomy [J]. International Medicine and Health Guidance News, 2024, 30(9): 1570-1574.

金荷莲冯宁翰过月红.

效率医疗背景下的全程护理模式对前列腺癌根治术患者的影响 [J]. 国际医药卫生导报, 2024, 30(9): 1570-1574.

References

[1] 邹雪霞,蒋旭. 破窗理论结合预见性护理用于腹腔镜前列腺癌根治切除术效果观察[J]. 国际医药卫生导报,2019,25(14):2384-2386.DOI:10.3760/cma.j.issn.1007-1245. 2019.14.058.
[2] 林军秀,刘菲菲,李莉. 快速康复护理干预策略在前列腺癌术后患者中的应用效果[J]. 国际护理学杂志,2022,41(22):4146-4149.DOI:10.3760/cma.j.cn221370-20211108- 01051.
[3] 张丽媚,文碧燕,余惠蚕,等. 负压治疗联合盆底肌训练对前列腺癌根治术后患者控尿功能及性功能的影响[J/CD]. 中华腔镜泌尿外科杂志(电子版),2022,16(1):28-30.DOI:10.3877/cma.j.issn.1674-3253.2022.01.006.
[4] 曹璐,李萍,王芸. 基于接纳与承诺疗法的延续性护理干预对机器人辅助腹腔镜前列腺癌根治术后患者负性情绪的影响[J]. 国际护理学杂志,2022,41(9):1712-1716.DOI:10.3760/cma.j.cn221370-20200428-00443.
[5] 过月红,王蕾,冯宁翰. 早期盆底肌功能锻炼结合膀胱训练在改善前列腺癌术后尿失禁方面的效果分析[J]. 国际医药卫生导报,2021,27(8):1136-1139.DOI:10.3760/cma.j.issn.1007-1245.2021.08.008.
[6] 唐燕,张雪燕,唐晓娟. 机器人辅助下前列腺癌根治术患者的围手术期护理及效果[J]. 中国医药导报,2022,19(32):164-167,183.DOI:10.20047/j.issn1673-7210.2022.32.38.
[7] 王玲,何雨晴,王琼,等. 围术期协同激励护理在腹腔镜前列腺癌根治术患者中的应用[J]. 齐鲁护理杂志,2021,27(6):84-86.DOI:10.3969/j.issn.1006-7256.2021.06.032.
[8] 李友芳,张娟,张培,等. 围术期快速康复护理结合临床路径在前列腺癌根治术患者中的应用价值[J]. 河北医药,2021,43(2):310-313.DOI:10.3969/j.issn.1002-7386. 2021.02.036.
[9] 沙岩,陈庆丽. 网络平台延续性护理对前列腺癌根治术尿失禁患者生活质量及自我效能的影响[J]. 现代中西医结合杂志,2020,29(27):3062-3065.DOI:10.3969/j.issn. 1008-8849.2020.27.024.
[10] 付冉冉,王琼,阎淑芹,等. 基于叙事干预的精益护理在行腹腔镜前列腺根治术前列腺癌患者中的应用[J]. 护理实践与研究,2021,18(3):414-417.DOI:10.3969/j.issn.1672-9676. 2021.03.028.
[11] 周敏,张静,何亚男,等. 基于正强化理论的全程管理对前列腺癌手术患者预后的影响[J]. 实用医院临床杂志,2023,20(1):75-79.DOI:10.3969/j.issn.1672-6170.2023.01.020.
[12] Milios JE, Ackland TR, Green DJ. Pelvic floor muscle training and erectile dysfunction in radical prostatectomy: a randomized controlled trial investigating a non-invasive addition to penile rehabilitation[J].Sex Med,2020,8(3):414-421.DOI:10.1016/j.esxm.2020.03.005.
[13] 王惠良,吴笑笑,郑晶晶,等. 延续护理对前列腺癌术后尿失禁患者控尿功能及生活质量的影响[J]. 中华现代护理杂志,2019,25(5):622-626.DOI:10.3760/cma.j.issn. 1674-2907.2019.05.024.
[14] 许献霞,陈振兰,黄英凡,等. 快速康复外科护理对前列腺癌根治术后患者控尿功能及康复结局的影响[J]. 长春中医药大学学报,2021,37(4):880-883.DOI:10.13463/j.cnki.cczyy.2021.04.046.
[15] 吴小桃,王晶. 精准化护理模式在腹腔镜下前列腺癌根治术围手术期应用及对术后并发症的影响[J]. 国际护理学杂志,2019,38(19):3241-3244.DOI:10.3760/cma.j.issn. 1673-4351.2019.19.050.
[16] 杨静静,吕燕玲,沈少仪,等. 认知行为护理对腹腔镜下前列腺癌根治术后勃起功能的影响分析[J]. 中国性科学,2023,32(2):34-37.DOI:10.3969/j.issn.1672-1993.2023.02.009.
[17] 吴春燕,李萍,李海燕,等. 多形式延续护理对前列腺癌根治术患者焦虑及生活质量的影响[J]. 护理学杂志,2019,34(17):76-78.DOI:10.3870/j.issn.1001-4152.2019. 17.076.