摘要
目的研究循证护理引导认知护理对肝胆外科经皮经肝胆管引流术(percutaneous transhepatic biliary drainage,PTBD)术后护理效果的影响。方法选取我院肝胆胰外科于2017年1月至2018年12月收治的62例接受PTBD的患者进行研究,按照随机数字表法,随机分为研究组和对照组,每组各31例。对照组给予常规认知护理,研究组则给予循证护理引导认知护理。观察并比较两组患者对PTBD和自身疾病的认知水平、心理状态情况、生活质量评分情况、并发症发生情况以及出院后自我护理情况。结果护理后,研究组对PTBD手术方法、手术适应症、术后并发症、并发症处理方法、疾病形成原理以及疾病对人体的危害等健康知识的认知水平评分显著高于对照组,两组比较差异具有统计学意义(P<0. 05)。研究组患者中积极配合治疗人数、心理状态平稳人数以及可接受带管时间超过3个月的人数均较对照组更多,两组比较差异具有统计学意义(P<0. 05)。两组角色功能、躯体功能、认知功能、情感功能、社会功能以及整体健康状况均较护理前显著改善,且研究组角色功能、认知功能、情感功能、社会功能以及整体健康状况改善情况明显优于对照组,而对照组躯体功能改善情况优于研究组(P<0. 05)。两组患者均发生感染和脱管,但研究组并发症发生率(9. 68%)明显低于对照组(35. 48%),两组比较差异有统计学意义(P<0. 05)。研究组抗返流引流袋使用人数、引流袋每周更换的人数、刺口一直高于引流袋的人数、无菌操作更换引流袋以及每天观察引流液情况的人数均显著多于对照组,两组比较差异具有统计学意义(P<0. 05)。结论循证护理引导认知护理不仅能提高患者对疾病的认知情况和对治疗的配合度,还能提高肝胆外科PTBD术后患者护理效果,降低术后感染和脱管的发生,改善患者生活质量和整体健康状况,值得临床�
Objective To observe the effect of evidence-based cognitive nursing on postoperative nursing care of patients with percutaneous transhepatic biliary drainage(PTBD)in hepatobiliary surgery.Methods 62 patients admitted to the Department of Hepatobiliary and Pancreatic Surgery of our hospital from January 2017 to December 2018 and treated with PTBD were selected and randomly divided into the study group and the control group,with 31 cases in each group.The control group was treated with conventional cognitive care,while the study group was given evidence-based nursing-guided care.Cognitive level,psychological status,score of quality of life,complications,and self-care status after discharge of PTBD were observed and compared between the two groups.Results After nursing,the study group scored significantly higher in terms of the cognitive level of PTBD surgery methods,surgical indications,postoperative complications,complications management methods,disease formation principles,and cognitive level of the health knowledge,such as harm of disease to human body than the control group.The differences were statistically significant(P<0.05).There was greater number of patients in the study group who actively cooperated with the treatment,could accept intubation time for more than 3 months and were in stable mental status than that in the control group,and the differences were statistically significant(P<0.05).The role function,physical function,cognitive function,emotional function,social function and overall health status of the two groups were significantly improved compared with those before nursing,and Moreover,the improvements of role function,cognitive function,emotional function,social function and overall health status of the study group were significantly better than those of the control group,while the improvement of physical function of the control group was better than that of the study group(P<0.05).Infection and dislocation occurred in both groups,but the incidence of complications in the study group(9.68%)was
作者
张爱华
林进源
Zhang Aihua;Lin Jinyuan(Hepatobiliary and Pancreatic Surgery,the People's Hospital of Yangjiang City,Yangjiang 529500 China)
出处
《锦州医科大学学报》
CAS
2019年第2期91-95,共5页
Journal of Jinzhou Medical University
关键词
循证护理
认知干预
肝胆外科
经皮经肝胆管引流术
术后康复
evidence-based nursing
cognitive intervention
hepatobiliary surgery
percutaneous transhepatic biliary drainage
postoperative rehabilitation
