Evaluation of the effect of immediate breast reconstruction combined with psychological intervention in breast cancer patients undergoing endoscopic surgery
乳腺癌患者乳腔镜手术即刻乳房重建联合心理干预的效果评价

摘要

目的 探究基于罗伊-纽曼系统的心理护理在悬吊式乳腔镜下保留皮肤乳头乳晕乳腺癌改良根治术即刻硅胶假体乳房重建乳腺癌患者的干预效果。方法 本研究采用回顾性分析，收集2019年1月1日至2020年11月30日于淄博市中心医院乳腺甲状腺外科及中国医科大学附属盛京医院行悬吊式乳腔镜下保留皮肤乳头乳晕乳腺癌改良根治术即刻硅胶假体乳房重建的早期乳腺癌患者。将统计患者分为2组，一组给予术后常规护理干预（对照组），一组为在术后常规护理基础上增加罗伊-纽曼系统的心理护理（观察组），比较两组患者术后每日活动时间、出院时间、干预前后疼痛程度、负性情绪的改善情况、护理质量的满意度。结果 术后观察组患者出院时间明显低于对照组（P＜0.05）；观察组术后每日活动时间多于对照组（P＜0.05），术后观察组患者疼痛程度明显低于常规护理组（P＜0.05）；观察组干预后的SAS、SDS评分均低于对照组（P＜0.05）；观察组护理质量满意度高于对照组（P<0.05）。结论 悬吊式乳腔镜下保留皮肤乳头乳晕乳腺癌改良根治术即刻硅胶假体乳房重建乳腺癌患者给予罗伊-纽曼系统的心理护理干预，可以明显降低患者疼痛程度及相关负性情绪的发生，增加了患者术后每日活动时间，缩短了患者出院时间，促进患者恢复，同时也提高了患者对护理质量的满意度。

Abstract

Objective: To explore the effect of psychological nursing based on Roy-Newman system on breast reconstruction with silicone prosthesis immediately after modified radical mastectomy for breast cancer with skin nipple and areola under suspended breast endoscopy.
Methods: In this study, retrospective analysis was used to collect early breast cancer patients who underwent modified radical mastectomy with skin-preserving nipple-areola breast cancer and immediate silicone prosthesis breast reconstruction from January 1, 2019 to November 30, 2020 in Breast Thyroid Surgery of Zibo Central Hospital and Shengjing Hospital Affiliated to China Medical University. The patients were divided into two groups. One group was given postoperative routine nursing intervention (control group), and the other group was added psychological nursing of Roy-Newman system on the basis of postoperative routine nursing (observation group). The daily activity time, discharge time, pain degree before and after intervention, improvement of negative emotions and satisfaction of nursing quality were compared between the two groups.
Results: The discharge time of patients in the observation group was significantly shorter than that in the control group (P < 0.05). The daily activity time of the observation group was more than that of the control group (P < 0.05). The degree of pain in the observation group was significantly lower than that in the routine nursing group (P < 0.05). The scores of SAS and SDS in the observation group after intervention were lower than those in the control group (P < 0.05). The nursing quality satisfaction of the observation group was higher than that of the control group (P < 0.05).
Conclusion  : The psychological nursing intervention of Roy-Newman system for patients with breast cancer undergoing immediate silicone prosthesis breast reconstruction after modified radical mastectomy for breast cancer with skin nipple-areola preserved under suspension-endoscopy can significantly reduce the pain degree of patients and the occurrence of related negative emotions, increase the daily activity time of patients after operation, shorten the discharge time of patients, promote the recovery of patients, and improve the satisfaction of patients with nursing quality.