摘要
目的探讨手术护理指导在围手术期对功能性垂体腺瘤患者疾病不确定感的影响作用。方法选取上海交通大学医学院附属瑞金医院2010年1月至2012年6月所收治的83例进行经鼻蝶入路手术治疗的功能性垂体腺瘤患者,采用完全随机化分组方法分成两组,其中观察组有46例,对照组有37例。观察组在围手术期进行详细手术护理指导,对照组进行常规的探视。所有患者在术前1d和术后3d探视结束后,采用Mishel疾病不确定感量表(MUIS)进行评估。同时分别比较两组中术后1d激素水平下降明显同下降不明显患者的疾病不确定感评分。结果观察组患者在术前1d和术后3d的MUIS平均评分为82.30±6.95和74.75±5.45,明显低于对照组的93.65±9.97和89.53±9.78,差异有高度统计学意义(P<0.01);观察组中术后3d的得分平均值低于术前1d,差异有统计学意义(P<0.05),而对照组前后比较差异无统计学意义(P>0.05)。各组中激素水平下降明显和激素水平下降不明显患者的疾病不确定感评分之间的差异均无统计学意义(P>0.05)。结论针对性的手术护理指导能显著降低功能性垂体腺瘤患者的疾病不确定感,而短期手术效果并不是影响患者术后疾病不确定感的主要因素。
Objective To evaluate the effect of nursing instruction on the uncertainty in illness of functional pituitary adenoma patients during periopcrative period. Methods Eighty-three functional pituitary adenoma patients, in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, undergoing nasal transsphenoidal approach surgery were recruited in the study from January 2010 to June 2012. They were divided into 2 groups, 46 patients in intervention group and 37 patients in control group, using simple randomization method. Particular nursing instructions were given to patients in intervention group on 1 day before operation and 3 days after operation, while patients in control group were given routine instructions. Following the instruction, all patients were assessed with the Mishel uncertainty illness scale （MUIS）. At the same time, in the two groups, the MUIS average scores on the postoperative day 3 were respectively compared with the differences between hormone level significant decline and without obvious decline in postoperative day 1. Results The uncertainty average score of patients in preoperative day 1 and postoperative day 3 in intervention group were 82.30 ± 6.95 and 74.75 ±5.45, lower than the corresponding 93.65 ±9.97 and 89.53 ±9.78 in control group. The differences were highly statistically significant （ P 〈 0.01 ）. The average score of 3 days postoperative was below 1 day preoperative in intervention group with significant difference （ P 〈 0. 05 ）, while that in control group was not significant （ P 〉 0. 05 ）. Furthermore, in the two groups, the difference of MUIS average score in postoperative day 3 between patients with hormone levels obvious decrease and without decrease had no statistical significance respectively （ P 〉 0. 05 ）. Conclusions Specific surgical nursing instruction can significantly reduce the functional pituitary adenoma patients disease uncertainty. Moreover, the short-term effect of surgery is not the main factor influencing the postoperative patients with disease uncertainty.
出处
《中华损伤与修复杂志（电子版）》
CAS
2013年第3期61-63,共3页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
关键词
护理指导
疾病不确定感
垂体腺瘤
Nursing instruction
Uncertainty in illness
Pituitary adenoma
