摘要
目的:探讨中西医结合肺康复护理方案在结核性脓胸行胸腔镜清除术患者中的应用效果。方法:采用前瞻性研究方法,于2021年10月至2022年12月,连续纳入浙江大学医学院附属杭州市胸科医院新入院的符合手术指征的结核性脓胸患者66例,采用随机数字表法分为观察组(33例)和对照组(33例)。对照组采用常规护理,观察组在对照组基础上采用《结核性脓胸行胸腔镜清除术患者中西医结合肺康复护理方案》。比较两组研究对象入院当天、术后第2天、出院当天、出院后1个月的肺功能、日常生活能力、焦虑水平,以及术后第2天疼痛水平和术后胸管留置时间情况。结果:研究对象经治疗出院后1个月,对照组完成干预者28例,完成率为84.8%(28/33),观察组完成干预者31例,完成率为93.9%(31/33)。出院前、出院后1个月观察组第1秒用力呼气容积(forced expiratory volume in one second,FEV 1)水平[中位数(四分位数)]分别为1.83(1.60,2.29)L和2.20(2.00,2.32)L,均明显高于对照组[分别为1.58(1.43,1.83)L和1.91(1.88,2.04)L],差异均有统计学意义(Waldχ^(2)值分别为8.947和7.285,P值分别为0.003和0.007);观察组用力肺活量(forced vital capacity,FVC)水平分别为2.50(2.30,2.64)L和2.65(2.45,2.79)L,均明显高于对照组[分别为2.21(2.20,2.49)L和2.55(2.35,2.69)L],差异均有统计学意义(Waldχ^(2)值分别为10.072和5.708,P值分别为0.002和0.017)。术后第2天,观察组巴氏指数评分[中位数(四分位数)]为55.0(55.0,70.0)分,明显高于对照组[50.0(40.0,53.8)分],差异有统计学意义(Waldχ^(2)值=14.009,P<0.001)。出院前和出院后1个月观察组焦虑评分分别为(54.52±4.89)分和(49.58±3.91)分,均明显低于对照组[分别为(57.43±4.77)分和(54.61±3.98)分],差异均有统计学意义(t值分别为5.338和23.907,P值分别为0.025和<0.001)。观察组术后胸管留置时间为9(7,9)d,明显少于对照组[9(8,10)d],差异有统计学意义(Z=-2.076,P=0.0
Objective:To explore the application effect of integrated traditional Chinese medicine(TCM)and Western medicine pulmonary rehabilitation nursing program in patients with tuberculous empyema undergoing thoracoscopic clearance.Methods:Using a prospective research method,66 newly admitted patients with tuberculous empyema who met surgical indications in Hangzhou Chest Hospital Affiliated with Zhejiang University School of Medicine from October 2021 to December 2022 were enrolled.They were randomly divided into observation group(33 cases)and control group(33 cases)using a random number table method.The control group received routine care,while the observation group received the Pulmonary rehabilitation nursing program of integrated traditional Chinese and Western medicine for patients with tuberculous empyema under thoracoscopic clearance in addition to the routine care.Lung function,daily living ability,anxiety level and postoperative chest tube indwelling time of the two groups on the day of admission,the second day after surgery,the day of discharge,and one month after discharge were compared,and the pain level on the second day after surgery were also compared.Results:One month after discharge after treatment,of the study subjects,28 cases in the control group completed the intervention,with a completion rate of 84.8%(28/33),and 31 cases in the observation group completed the intervention,with a completion rate of 93.9%(31/33).The median(quartile)levels of forced expiratory volume in one second in the observation group before discharge and one month after discharge were 1.83(1.60,2.29)L and 2.20(2.00,2.32)L,respectively,which were significantly higher than those in the control group(1.58(1.43,1.83)L and 1.91(1.88,2.04)L),with statistical significance(Waldχ^(2)=8.947,P=0.003;and Waldχ^(2)=7.285,P=0.007,respectively);the forced vital capacity levels in the observation group were 2.50(2.30,2.64)L and 2.65(2.45,2.79)L,respectively,significantly higher than those in the control group(2.21(2.20,2.49)L,Waldχ^(2)=10.0
作者
高丹
王玲华
黄金鹏
张玥
毛潇潇
Gao Dan;Wang Linghua;Huang Jinpeng;Zhang Yue;Mao Xiaoxiao(Tuberculosis Treatment Center,Affiliated Hangzhou Chest Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)
出处
《中国防痨杂志》
CAS
CSCD
2023年第10期940-948,共9页
Chinese Journal of Antituberculosis
基金
浙江省中医药管理局(2020ZB185)
杭州市卫生健康委员会(2018A41)。
关键词
脓胸
结核性
胸腔镜
康复护理
临床方案
方案评价
Empyema,tuberculous
Thoracoscopes
Rehabilitation nursing
Clinical protocols
Program Evaluation
