摘要
目的 探讨行腹腔镜子宫肌瘤切除术的患者围术期应用同质医疗理念的创新型护理后,相关应激指标的变化.方法 随机选取2014年1月—2015年1月腹腔镜子宫肌瘤切除行常规护理患者45例,作为对照组;2015年2月—2016年1月行腹腔镜子宫肌瘤切除开展创新型护理患者45例,作为观察组,比较两组患者术前1 d、气腹后10 min、手术结束时3个时间点的心率（HR）、平均动脉压（MAP）、血糖以及去甲肾上腺素（NE）、肾上腺素（E）水平的差异.结果 对照组在气腹后10 min时的HR、MAP以及血糖水平均显著高于术前1 d,且在手术结束时有回落,但仍较术前1 d水平高,差异有统计学意义（P〈0.05）;观察组在气腹后10 min的HR、MAP、血糖水平均明显低于对照组,手术结束时的MAP低于对照组,差异有统计学意义（P〈0.05）.对照组患者血浆NE、E、皮质醇水平在气腹后10 min各值均显著升高,手术结束时有所下降,但仍明显高于术前1 d水平,组间比较差异有统计学意义（P〈0.05）,观察组的变化趋势同于对照组,且在气腹后10 min、手术结束时各值均明显低于对照组水平,差异有统计学意义（P〈0.05）.结论 同质医疗理念的创新型护理实践能显著降低腹腔镜子宫肌瘤切除患者围术期应激反应,促进术后恢复.
Objective To explore the change of stress related index after the application of innovative nursing practice based on the idea of homogeneous medical treatment in patients with laparoscopic myomectomy during the perioperative period.Methods We randomly selected 45 patients with laparoscopic myomectomy combined with conventional nursing acted as control group from January 2014 to January 2015. We also selected 45 patients with laparoscopic myomectomy combined with innovative nursing acted as innovation group from February 2015 to January 2016. The heart rate （HR）, mean arterial pressure （MAP）, blood glucose （BG）, noradrenaline （NE） and epinephrine （E） of both groups were compared one day before surgery, ten minutes after pneumoperitoneum and at the end of surgery.Results The HR, MAP and BG of the control group ten minutes after pneumoperitoneum was significantly higher than those one day before surgery. Compared with those of the control group at the end of surgery, these indexes ten minutes after pneumoperitoneum were fall after rise and were higher than those one day before surgery with a significant difference （P〈0.05）. The HR, MAP and BG ten minutes after pneumoperitoneum of the innovation group was significantly lower than those of the control group; the MAP at the end of surgery of the innovation group was lower than that of the control group with significant differences （P〈0.05）. The NE, E and hydrocortisone of the control group all increased significantly ten minutes after pneumoperitoneum, declined at the end of surgery and was significantly higher than those one day before surgery with significant differences （P〈0.05）. The innovation group had the same variation trend with the control group. Besides, these indexes ten minutes after pneumoperitoneum and at the end of surgery in the innovation group were lower than those in the control group with significant differences （P〈0.05）.Conclusions The innovative nursing practice based on the idea of homogeneous medical
出处
《中华现代护理杂志》
2017年第32期4148-4151,共4页
Chinese Journal of Modern Nursing
关键词
子宫肌瘤
应激反应
创新型护理
同质医疗
Leiomyoma
Stress
Innovative nursing
Homogeneous medical treatment
