目的:探讨5·12汶川地震中因外伤而截肢的患者产生各种心理反应的原因和护理对策,以采用有效的护理措施。方法:以我院收治的地震伤致截肢患者23例为研究对象,采用面对面与患者及家属交谈、观察患者的心理行为、转院后随访等形式,用应对方式量表对心理护理进行评分及分析,并针对性采取心理护理。结果:截肢患者在治疗前后出现自我概念改变、不确定感、社会适应力改变等正性和负性心理效应;经过心理护理,能消除心理障碍,均获得较好的治疗效果。结论:正确的心理分析和针对性心理护理有利于患者的心理调适,产生正性心理效应,积极应对疾病。
ObjectiveTo investigate the safety, economic benefits and psychological effects of day breast conserving surgery for breast cancer. MethodsThe demographic data and clinical data of breast cancer patients undergoing day (day surgery group) and ward (ward surgery group) breast conserving surgeries in West China Hospital of Sichuan University from March 2020 to June 2021 were retrospectively collected; the demographic data, clinical data, medical and related transportation costs, and preoperative and postoperative BREAST-Q scores of breast cancer patients undergoing day (day surgery group) and ward (ward surgery group) breast conserving surgery in West China Hospital of Sichuan University from July 2021 to May 2022 were prospectively collected. The safety, economic benefit, and psychological satisfaction of day surgery was analyzed ResultsA total of 42 women with breast cancer were included in the retrospective study and 39 women with breast cancer were included in the prospective study. In both prospective and retrospective studies, the mean age of patients in both groups were <50 years. There were only statistical differences between the two groups in the aspects of hypertension (P=0.022), neoadjuvant chemotherapy (P=0.037) and postoperative pathological estrogen receptor (P=0.033) in the prospective study. In postoperative complications, there were no statistical differences in the surgical-related complications or anesthesia-related complications between the two groups in either the prospective study or the retrospective study (P>0.05). In terms of the overall cost, we found that the day surgery group was more economical than the ward surgery group in the prospective study (P=0.002). There were no statistical differences in postoperative psychosocical well-being, sexual well-being, satisfaction with breasts and chest condition between the two groups (P>0.05). ConclusionIt is safe and reliable to carry out breast conserving surgery in day surgery center under strict management standards, which can save medical costs and will not cause great psychological burden to patients.