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中华普外科手术学杂志(电子版) ›› 2025, Vol. 19 ›› Issue (04) : 409 -412. doi: 10.3877/cma.j.issn.1674-3946.2025.04.016.

论著

五定四观察循证方案对直肠癌造口患者生活质量与应用效果的影响
辛林璞1, 杨敏1,(), 杜峻峰1,2,()   
  1. 1. 100700 北京,中国人民解放军总医院第七医学中心普通外科
    2. 100853 北京,中国人民解放军总医院第一医学中心普通外科医学部
  • 收稿日期:2025-02-18 出版日期:2025-08-26
  • 通信作者: 杨敏, 杜峻峰
  • 基金资助:
    北京市自然科学基金(7242034)

The influence of the evidence-based program of “five fixations and four observations” on the quality of life and application effect of patients with rectal cancer stoma

Linpu Xin1, Min Yang1,(), Junfeng Du1,2,()   

  1. 1. Department of General Surgery, 7th Medical Center of PLA General Hospital, Beijing 100700, China
    2. Medical Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2025-02-18 Published:2025-08-26
  • Corresponding author: Min Yang, Junfeng Du
引用本文:

辛林璞, 杨敏, 杜峻峰. 五定四观察循证方案对直肠癌造口患者生活质量与应用效果的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(04): 409-412.

Linpu Xin, Min Yang, Junfeng Du. The influence of the evidence-based program of “five fixations and four observations” on the quality of life and application effect of patients with rectal cancer stoma[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 409-412.

目的

探讨五定四观察循证护理方案在直肠癌术后造口患者中的应用效果及其对并发症和生活质量的影响。

方法

选取2021年1月至2024年6月收治的80例直肠癌造口患者为研究对象,按数字表法随机分为观察组和对照组,每组患者各40例。对照组实施常规护理,观察组在常规护理基础上采用五定四观察循证护理方案。采用SPSS 22.0统计学软件分析数据,计量资料以()表示,采用独立样本t检验;计数资料以[例(%)]表示,采用χ2检验。P<0.05为差异有统计学意义。

结果

观察组患者护理满意度显著高于对照组(95.0% vs. 77.5%,P<0.05),并发症总发生率显著降低(12.5% vs.35.0%,P<0.05)。干预后,观察组自我护理能力(ESCA)及生活质量(EORTC QLQ-C30)评分均高于对照组(均P<0.05)。

结论

五定四观察循证护理方案可有效提升直肠癌造口患者的护理满意度,降低并发症发生率,改善其自我护理能力及生活质量,具有临床推广价值。

Objective

To explore the application effect of the evidence-based nursing program of “five fixations and four observations” in patients with stoma after rectal cancer surgery and its influence on complications and quality of life.

Methods

A total of 80 patients with stoma after rectal cancer surgery admitted from January 2021 to June 2024 were selected as the research subjects. They were randomly divided into the observation group and the control group according to the random number table method, with 40 patients in each group. The control group received routine nursing care, and the observation group adopted the evidence-based nursing program of “five fixations and four observations” on the basis of routine nursing care.The SPSS 22.0 statistical software was used to analyze the data. Measurement data were expressed as (),and independent sample t tests were used; Enumeration data were expressed as [cases (%)], and χ2 tests were performed. P<0.05 was considered to indicate a statistically significant difference.

Results

The nursing satisfaction of the patients in the observation group was significantly higher than that in the control group (95.0% vs. 77.5%, P<0.05), and the total incidence of complications was significantly reduced (12.5%vs. 35.0%, P<0.05). After the intervention, the scores of self-care ability (ESCA) and quality of life (EORTC QLQ-C30) in the observation group were both higher than those in the control group (both P<0.05).

Conclusion

The evidence-based nursing program of “five fixations and four observations” can effectively improve the nursing satisfaction of patients with stoma after rectal cancer, reduce the incidence of complications, and improve their self-care ability and quality of life, which has clinical promotion value.

表1 两组直肠癌造口患者一般资料比较
表2 两组直肠癌造口患者护理满意度比较[例(%)]
表3 两组直肠癌造口患者并发症发生率比较[例(%)]
表4 两组直肠癌造口患者ESCA评分比较(分,
表5 两组直肠癌造口患者EORTC QLQ-C30评分比较(分,
[1]
郑民华,蒋天宇,赵轩,等. 中国腹腔镜直肠癌根治术30年发展历程与未来[J/CD]. 中华普外科手术学杂志(电子版),2024, 18(06): 591-596.
[2]
池畔,黄胜辉. 中国腹腔镜直肠癌根治术30年来的巨大进步[J/CD]. 中华普外科手术学杂志(电子版),2024, 18(06):597-601.
[3]
郑民华,马君俊. 不断推进中国腹腔镜直肠癌手术规范化[J/CD]. 中华普外科手术学杂志(电子版),2023, 17(05): 473-476.
[4]
陈孝平,汪建平,赵继宗. 外科学[M]. 9版. 北京:人民卫生出版社,2018: 421-428.
[5]
Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice [M]. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2017: 345-360.
[6]
李小寒,尚少梅. 基础护理学[M]. 7版. 北京:人民卫生出版社,2020: 255-268.
[7]
王建荣. 循证护理的基本理论与实践[M]. 北京:人民军医出版社,2012: 156-178.
[8]
王才康,胡中锋,刘勇. 一般自我效能感量表的信度和效度研究[J]. 应用心理学,2001, 7(01): 37-40.
[9]
Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology [J]. J Natl Cancer Inst, 1993, 85(5): 365-376.
[10]
万崇华,方积乾,汤学良,等. 癌症患者生命质量测定量表EORTC QLQ-C30中文版评介[J]. 实用肿瘤杂志,2021,20(04): 353-355.
[11]
王萌,王沛,侯翠萍. 循证护理在长期膀胱造口病人护理中的应用及效果评价[J]. 齐齐哈尔医学院学报,2018, 29(20):2522-2523.
[12]
孔鸽. 循证护理在肛门造瘘术后的应用效果分析[J]. 河南医学研究,2024, 11: 140-142.
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