本文選題：乳腺癌 + 康復(fù)期　； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：研究目的探討采用個案管理對控制早期乳腺癌患者康復(fù)期體重的效果,并觀察體重控制對患者康復(fù)期血脂、血糖、血紅蛋白及健康行為能力和生存質(zhì)量的影響。研究方法本研究為類實驗性研究。按照納入排除標(biāo)準(zhǔn),遴選鄭州市某三級甲等綜合醫(yī)院乳腺外科進(jìn)行保乳術(shù)或改良根治術(shù)、術(shù)后進(jìn)行8個療程化療的早期乳腺癌患者30名為對照組,選取鄭州市另一三級甲等綜合醫(yī)院乳腺外科進(jìn)行保乳術(shù)或改良根治術(shù)、術(shù)后并進(jìn)行8個療程化療的早期乳腺癌患者30名為干預(yù)組;對照組實行常規(guī)健康教育,干預(yù)組在常規(guī)健康教育基礎(chǔ)上,實行基于個案管理模式的體重控制;兩組分別于化療前、化療中期、化療結(jié)束收集患者一般資料、體重、血糖血脂、血紅蛋白、健康行為能力及生存質(zhì)量狀況并進(jìn)行評估;采用IBM SPSS Statistics 20.0對數(shù)據(jù)進(jìn)行統(tǒng)計分析,方法為:描述性分析、卡方檢驗、非參數(shù)檢驗、重復(fù)測量方差分析、t檢驗,檢驗水準(zhǔn)為α=0.05,P0.05有統(tǒng)計學(xué)差異。研究結(jié)果1.至研究結(jié)束,共有55名患者納入統(tǒng)計分析。兩組一般資料對比無統(tǒng)計學(xué)差異(P0.05);干預(yù)前兩組體重、BMI、血糖血脂、血紅蛋白、健康行為能力得分及生存質(zhì)量得分均無統(tǒng)計學(xué)差異(P0.05);兩組具有可比性。2.化療結(jié)束后干預(yù)組體重平均增加(0.82±2.37)kg;對照組體重平均增加(6.52±3.66)kg,對比有統(tǒng)計學(xué)差異(P0.05);體重變化分類及超重肥胖率對比有統(tǒng)計學(xué)差異(P0.05)。兩組體重、BMI在化療前、化療中期、化療結(jié)束三個時間點測量結(jié)果方差分析時間效應(yīng)有統(tǒng)計學(xué)意義(P0.05),隨化療的進(jìn)行,兩組體重與BMI均有所增加;組別效應(yīng)有統(tǒng)計學(xué)意義(P0.05),干預(yù)組體重、BMI狀況優(yōu)于對照組。3.兩組患者的血糖、總膽固醇、甘油三脂、低密度脂蛋白、血紅蛋白在化療前、化療中期、化療結(jié)束三個時間點測量結(jié)果方差分析顯示時間效應(yīng)有統(tǒng)計學(xué)差異(均P0.05),隨化療的進(jìn)行而變化;血糖、總膽固醇、低密度脂蛋白組間比較有統(tǒng)計學(xué)差異(均P0.05),干預(yù)組優(yōu)于對照組。4.健康行為能力與生存質(zhì)量方面,化療結(jié)束后,兩組患者健康行為能力總分及各維度得分上差異均有統(tǒng)計學(xué)意義(P0.05);生存質(zhì)量總得分及生理狀況、情感狀況、功能狀況、乳腺癌附加關(guān)注四個維度上得分差異有統(tǒng)計學(xué)意義P0.05)。結(jié)論1.以飲食運動為主要方式的個案管理能夠在一定程度上控制乳腺癌患者康復(fù)期體重增加的趨勢。2.體重控制可以在一定程度上改善患者化療期間的血糖血脂水平。3.體重控制有利于患者養(yǎng)成良好的生活習(xí)慣,提高健康行為能力,維持較好的自我形象,改善生存質(zhì)量。
[Abstract]:Objective to investigate the effect of case management on early breast cancer patients' recovery weight, and to observe the effects of weight control on blood lipid, blood glucose, hemoglobin, healthy behavior and quality of life. Methods this study is an experimental study. According to the exclusion criteria, 30 patients with early breast cancer who received 8 courses of chemotherapy were selected as the control group for breast surgery or modified radical mastectomy in a Grade 3A general hospital in Zhengzhou. Thirty patients with early breast cancer who underwent breast conservation or modified radical mastectomy in another Grade 3A general hospital in Zhengzhou were selected as the intervention group and the control group were given routine health education. On the basis of routine health education, the intervention group carried out the weight control based on the case management model, and the two groups collected the general data of patients before and during the middle stage of chemotherapy and the end of chemotherapy, including body weight, blood glucose, blood lipid, hemoglobin. IBM SPSS Statistics 20.0 was used to analyze the data. The methods were: descriptive analysis, chi-square test, nonparametric test, repeated measurement variance analysis. There was statistical difference in the test level of 偽 -0. 05 and 0. 05% (P < 0. 05). Results 1. By the end of the study, 55 patients had been included in the statistical analysis. There was no significant difference in general data between the two groups (P 0.05), and there was no significant difference in blood glucose, blood lipid, hemoglobin, health behavior ability and quality of life between the two groups before intervention (P 0.05). The time effect of ANOVA was statistically significant at three time points before and after chemotherapy in both groups. The weight and BMI of the two groups increased with the development of chemotherapy. The group effect was significantly higher than that of control group (P 0.05), and the BMI of intervention group was better than that of control group (P 0.05). The blood sugar, total cholesterol, triglyceride, low density lipoprotein, hemoglobin in both groups were before and during the middle stage of chemotherapy. The variance analysis of the three time points at the end of chemotherapy showed that there was a significant difference in time effect (all P 0.05), which varied with the course of chemotherapy, blood sugar, total cholesterol, blood glucose, total cholesterol, There was significant difference between the low density lipoprotein groups (all P 0.05), the intervention group was better than the control group. 4. In terms of health behavior ability and quality of life, after chemotherapy, there were significant differences in the total score and dimension scores of healthy behavior ability between the two groups (P 0.05), the total score of quality of life and physiological status, emotional status, functional status, and so on. There was significant difference in the score of breast cancer among the four dimensions (P 0.05). Conclusion 1. Diet exercise as the main mode of case management can to some extent control breast cancer patients during the recovery of weight gain trend. 2. Weight control can improve blood glucose and blood lipid level. 3. 3. Weight control can help patients to develop good living habits, improve healthy behavior, maintain a good self-image, and improve the quality of life.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73

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