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腹腔镜子宫肌瘤剔除术与综合康复护理对子宫肌瘤患者的应用效果。

Application Effect of Laparoscopic Myomectomy and Comprehensive Rehabilitation Nursing on Patients with Uterine Fibroids.

机构信息

Department of Obstetrics and Gynecology, Zunhua People's Hospital, Hebei, China.

Department of Obstetrics and Gynecology, Zhengding Maternal and Child Health Hospital, Shijiazhuang, Hebei, China.

出版信息

Comput Math Methods Med. 2022 Sep 22;2022:4018803. doi: 10.1155/2022/4018803. eCollection 2022.

Abstract

BACKGROUND

Uterine fibroids are most common in women aged 30-50 and are the most common benign gynecological tumors. Relevant data suggest that about 25% of patients with uterine fibroids are at childbearing age. Uterine fibroids not only cause the discomfort symptoms, and affect the pregnancy, but also have certain malignant transformation risk, thus needed to be treated positively and promptly.

AIM

This study is aimed at exploring the effect of laparoscopic myomectomy and comprehensive rehabilitation nursing on patients with uterine fibroids.

METHODS

The clinical data of 110 cases of uterine fibroids admitted to our hospital from August 2019 to December 2021 were analyzed retrospectively, and they were divided into two groups according to postoperative rehabilitation strategies. Both groups were treated with laparoscopic myomectomy. The A group was treated with routine rehabilitation strategy, while the B group was treated with comprehensive rehabilitation nursing strategy. The differences in operation-related indicators, stress factors, inflammatory factors, nutritional indicators, knowledge mastery, occurrence of adverse symptoms and pain scores, negative emotion scores, nursing satisfaction, and simplified comfort status scale (GCQ) scores between the two groups under nursing strategies were compared.

RESULTS

The postoperative exhaust time (13.14 ± 2.03) h, bed time (9.86 ± 1.94) h, postoperative hospital stay (4.37 ± 1.31) d, and total hospital stay (6.78 ± 1.69) d in the B group were shorter than those in the A group, and the hospitalization expenses (0.74 ± 0.25) million were less than those in the A group ( < 0.05). Before operation, stress factors, inflammatory factors, and nutritional indexes were compared between the two groups ( > 0.05). On the 3rd day after operation, tumor necrosis factor- (TNF-), cortisol (Cor), norepinephrine (NE), and interleukin-1 (IL-1) in the two groups showed a significantly upward trend compared with those before operation, and albumin and transferrin were significantly fell compared with those before operation. However, the values of stress factor and inflammatory factor in the B group were significantly lower than those in the A group, and the values after the decrease of nutritional index were significantly higher than those in the A group ( < 0.05). The pain scores at 24 h, 48 h, and 72 h after operation in the B group were significantly lower than those in the A group ( < 0.05). Negative emotions, nursing satisfaction, and GCQ scores were compared between the two groups before intervention ( > 0.05). After the intervention, the scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the two groups were significantly lower than those before the intervention, and the scores of nursing satisfaction and GCQ were higher than those before the intervention. The values of negative emotions in the B group after the decline were significantly lower than those in the A group, while the values of nursing satisfaction and GCQ after the increase were higher than those in the A group ( < 0.05). The excellent and good rate of knowledge acquisition in the B group was 94.55% (52/55), which was significantly higher than 78.18% (43/55) in the A group ( < 0.05). The incidence of adverse symptoms in the B group was 9.09% (5/55), which was lower than 21.82% (12/55) in the A group, while the difference was not statistically significant ( > 0.05).

CONCLUSION

Laparoscopic myomectomy combined with comprehensive rehabilitation nursing can reduce the postoperative stress state of patients with uterine fibroids, improve patient satisfaction, reduce adverse emotions, and promote rehabilitation.

摘要

背景

子宫肌瘤在 30-50 岁的女性中最为常见,是最常见的良性妇科肿瘤。相关数据表明,约 25%的子宫肌瘤患者处于生育年龄。子宫肌瘤不仅会引起不适症状,影响妊娠,而且还具有一定的恶变风险,因此需要积极、及时地进行治疗。

目的

探讨腹腔镜子宫肌瘤剔除术联合综合康复护理对子宫肌瘤患者的影响。

方法

回顾性分析我院 2019 年 8 月至 2021 年 12 月收治的 110 例子宫肌瘤患者的临床资料,根据术后康复策略分为两组。两组均行腹腔镜子宫肌瘤剔除术,A 组采用常规康复策略,B 组采用综合康复护理策略。比较两组护理策略下手术相关指标、应激因素、炎症因子、营养指标、知识掌握情况、不良反应及疼痛评分、负性情绪评分、护理满意度及简化舒适状况量表(GCQ)评分的差异。

结果

B 组术后排气时间(13.14±2.03)h、卧床时间(9.86±1.94)h、术后住院时间(4.37±1.31)d、总住院时间(6.78±1.69)d均短于 A 组,住院费用(0.74±0.25)万元少于 A 组(<0.05)。术前两组应激因素、炎症因子、营养指标比较(>0.05)。术后第 3 天,两组肿瘤坏死因子-(TNF-)、皮质醇(Cor)、去甲肾上腺素(NE)、白细胞介素-1(IL-1)均呈上升趋势,与术前比较均升高,白蛋白、转铁蛋白均下降,与术前比较均降低,但 B 组应激因子和炎症因子水平均低于 A 组,营养指标下降后水平均高于 A 组(<0.05)。B 组术后 24、48、72 h 疼痛评分均低于 A 组(<0.05)。两组干预前负性情绪、护理满意度、GCQ 评分比较(>0.05)。干预后两组汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分均低于干预前,护理满意度和 GCQ 评分均高于干预前。B 组干预后负性情绪评分下降值低于 A 组,护理满意度和 GCQ 评分上升值高于 A 组(<0.05)。B 组知识掌握优良率为 94.55%(52/55),高于 A 组的 78.18%(43/55)(<0.05)。B 组不良反应发生率为 9.09%(5/55),低于 A 组的 21.82%(12/55),但差异无统计学意义(>0.05)。

结论

腹腔镜子宫肌瘤剔除术联合综合康复护理可减轻子宫肌瘤患者术后应激状态,提高患者满意度,减轻负性情绪,促进康复。

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