| 引用本文: |
熊琪, 程顺花.预见性中医护理联合常规护理对膀胱癌术后膀胱灌注化疗患者的临床疗效[J].湖南中医药大学学报,2025,45(8):1578-1584[点击复制] |
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| 预见性中医护理联合常规护理对膀胱癌术后膀胱灌注化疗患者的临床疗效 |
| 熊琪,程顺花 |
| (湖南中医药大学第二附属医院泌尿外科, 湖南 长沙 410005;中南大学湘雅二医院泌尿外科, 湖南 长沙 410010) |
| 摘要: |
| 目的 探讨在常规护理基础上进行预见性中医护理干预对膀胱癌术后膀胱灌注化疗患者临床疗效的影响。方法 选取膀胱癌术后膀胱灌注化疗患者100例，随机分为对照组与观察组，每组50例。对照组接受常规护理（包括膀胱灌注管理和心理疏导）；观察组在对照组基础上联合预见性中医护理干预系列措施，两组患者干预周期均为2个月。评估两组患者干预前、干预1个月和干预2个月的膀胱容量、O'Leary-Sant间质性膀胱炎症状指数（ICSI）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、匹兹堡睡眠质量指数（PSQI）、失眠严重指数量表（ISI）、简易生活质量量表（SF-36）评分及化疗完成率、不良反应发生率及预后状况等指标变化。结果 与干预前比较、干预1个月比较、对照组比较，观察组干预2个月膀胱容量均显著增加（P<0.01）。与干预前相比，干预1个月与干预2个月后两组O'Leary-Sant ICSI、HAMA、HAMD、PSQI、ISI评分均显著降低（P<0.01），且干预2个月的上述评分低于干预1个月的评分（P<0.01）；两组SF-36评分均升高（P<0.05,P<0.01），且干预2个月评分高于干预1个月的评分（P<0.01）。与对照组相比，干预1个月及干预2个月后的观察组O'Leary-Sant ICSI、HAMA、HAMD、PSQI、ISI评分均显著降低（P<0.01）,SF-36评分升高（P<0.05,P<0.01）。与对照组相比，观察组患者在干预1个月及干预2个月的化疗完成率更高（P<0.05），化疗相关不良反应发生率更低（P<0.05），遵医行为及预后情况更好（P<0.05,P<0.01）。结论 预见性中医护理干预可在常规护理基础上有效改善膀胱癌术后膀胱灌注化疗患者的生理状态、心理健康及治疗依从性，具有良好的临床推广应用价值。 |
| 关键词: 膀胱癌 中医护理 预见性护理 膀胱灌注化疗 膀胱容量 汉密尔顿焦虑量表 |
| DOI：10.3969/j.issn.1674-070X.2025.08.028 |
| 投稿时间：2024-12-27 |
| 基金项目:湖南省发展和改革委员会科学研究项目(湘发改投资[2021]212号) |
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| Clinical efficacy of predictive Chinese medicine nursing combined with routine care for postoperative intravesical chemotherapy in bladder cancer patients |
| XIONG Qi, CHENG Shunhua |
| (Department of Urology, The Second Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410005, China;Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410010, China) |
| Abstract: |
| Objective To investigate the clinical impact of predictive Chinese medicine（CM） nursing intervention combined with routine care on postoperative bladder cancer（PBC） patients undergoing intravesical chemotherapy. Methods A total of 100PBC patients scheduled for intravesical chemotherapy were enrolled and randomly divided into two groups: a control group and an observation group, with 50 cases in each group. The control group received routine nursing care, including intravesical chemotherapy management and psychological counseling. The observation group received the same routine care supplemented with a series of predictive CM nursing interventions. Both groups underwent a 2-month intervention period. The changes in bladder capacity, O’Leary-Sant interstitial cystitis symptom index（ICSI）, Hamilton anxiety scale（HAMA）, Hamilton depression scale（HAMD）,Pittsburgh sleep quality index（PSQI）, insomnia severity index（ISI）, short form-36 health survey（SF-36） scores, as well as chemotherapy tolerance, incidence of adverse reactions, medical compliance behavior, and prognosis status were evaluated in the two groups of patients before the intervention, at 1-month and 2-month post-intervention. The intervention effects were then compared. Results Compared with the levels before intervention and at 1-month post-intervention, as well as with the control group, the observation group demonstrated a significant increase in bladder capacity at 2-month post-intervention（P＜0.01）. For both groups, scores on ICSI,HAMA, HAMD, PSQI, and ISI decreased significantly at 1-month and 2-month post-intervention compared with the pre-intervention levels（P＜0.01）, with lower scores observed at 2-month than at 1-month（P＜0.01）. Conversely, SF-36 scores increased significantly in both groups over time（P＜0.05, P＜0.01）, with higher scores at 2-month than at 1-month（P＜0.01）. Compared with the control group,scores on ICSI, HAMA, HAMD, PSQI, and ISI were significantly lower in the observation group at both 1-month and 2-month postintervention（P＜0.01）, while SF-36 scores were both higher（P＜0.05, P＜0.01）. Additionally, compared with the control group, the observation group exhibited higher chemotherapy completion rates（P＜0.05）, lower incidence of chemotherapy-related adverse reactions（P＜0.05）, and better treatment compliance and prognosis at both 1-month and 2-month post-intervention（P＜0.05, P＜0.01）. Conclusion Predictive CM nursing interventions can effectively ameliorate physiological status, psychological well-being, and treatment compliance in PBC patients undergoing intravesical chemotherapy beyond routine care alone, demonstrating significant clinical applicability. |
| Key words: bladder cancer Chinese medicine nursing predictive nursing intravesical chemotherapy bladder capacity Hamilton anxiety rating scale |
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