摘要
目的 探讨全方位精细化护理在心脏瓣膜置换术(HVR)患者中的应用价值。方法 选取2020-06-01-2022-06-30驻马店市中心医院收治的106例HVR术后患者为研究对象,根据护理方案不同,分为常规护理组和精细化护理组,各53例。常规护理组给予常规的护理干预,精细化护理组在常规护理的基础上给予全方位精细化护理。对比2组康复进程、应激指标[皮质醇、促肾上腺皮质激素(ACTH)、胰岛素]水平、疼痛程度[视觉模拟量表(VAS)评分]、心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分]、生活质量(LHFQ评分)及满意度。结果 精细化护理组ICU监护时间、住院时间分别为(37.14±4.18) h、(20.31±1.24) d,短于常规护理组的(45.76±5.39) h、(22.11±0.73) d,差异有统计学意义,t值分别为9.200和9.107,均P<0.001。术后5 d,精细化护理组VAS评分、血清皮质醇、ACTH、胰岛素水平分别为(3.04±0.85)分、(269.11±30.95) nmol/L、(18.13±1.89) pmol/L、(12.87±2.46) mmol/L,低于常规护理组的(3.49±0.67)分、(289.67±36.58) nmol/L、(23.64±2.14) pmol/L、(15.49±3.08) mmol/L,差异有统计学意义,F值分别为7.654、4.881、100.529和12.203,P值分别为0.001、0.009、<0.001和<0.001。干预后,精细化护理组SAS、SDS评分分别为(42.57±3.18)、(41.32±4.00)分,低于常规护理组的(47.64±4.42)、(48.23±3.76)分;LHFQ评分为(86.96±5.79)分,高于常规护理组的(77.45±6.02)分,差异有统计学意义,F值分别为26.073、41.733和34.484,均P<0.001。精细化护理组总满意度为96.23%,高于常规护理组的81.13%,差异有统计学意义,χ^(2)=6.014,P=0.014。结论 全方位精细化护理干预可改善HVR术后患者的负性情绪状态,缓解疼痛程度及应激反应,有助于加快康复进程,改善患者HVR术后的生活质量。
Objective To explore the application value of comprehensive refined nursing in patients undergoing heart valve replacement(HVR).Methods A total of 106 postoperative patients with HVR admitted to Zhumadian Central Hospital from June l,2020 to June 30,2022 were detected prospectively.According to different nursing plans,they were divided into routine nursing group and refined nursing group,with 53 patients in each group.The routine nursing group received routine nursing intervention,while the refined nursing group received comprehensive refined nursing on the basis of the routine nursing group.The rehabilitation progress,stress indicators[cortisol,adrenocorticotropic hormone(ACTH),insulin levels],pain levell visual analogue scale(VAS)score],psychological state[self-rating anxiety scale(SAS),self-rating depression scale(SDS)score],quality of life[Minnesota living with heart failure questionnaire(LHFQ)]score,and satisfaction were compared between the two groups.Results The ICU monitoring time and hospitalization time in the refined nursing group were(37.14±4.18)hours and(20.31±1.24)days,respectively,which were shorter than those in the routine nursing group(45.76±5.39)hours and(22.11±0.73)days,and the difference was statistically signifi-cant(the F values were 9.200,9.107,all P<0.001);Five days after surgery,the VAS score,serum cortisol,ACTH,and insulin levels in the refined nursing group were(3.04±0.85)points,(269.11±30.95)nmol/L,(18.13±1.89)pmol/L,and(12.87±2.46)mmol/L,respectively,which were lower than those in the conventional care group(3.49±0.67)points,(289.67±36.58)nmol/L,(23.64±2.14)pmol/L,and(15.49±3.08)mmol/L,the difference was statistically significant(the F values were 7.654,4.881,100.529,12.203,the P values were 0.001,0.009,<0.001,<0.001);After intervention,the SAS score and SDS score in the refined nursing group were(42.57±3.18)points,(41.32±4.00)points,which were lower than those in the routine nursing group(47.64±4.42)points,(48.23±3.76)points,and the LHFQ score was(86.96±5.79)points,
作者
吕乐乐
侯颖慧
胡岩
徐新莉
LYU Lele;HOU Yinghui;HU Yan;XU Xinli(Cardiovascular Intensive Care Unit,Zhumadian Central Hospital,Zhumadian 463000,China)
出处
《社区医学杂志》
CAS
2023年第18期955-960,共6页
Journal Of Community Medicine
关键词
精细化护理
心脏瓣膜置换术
应激反应
康复进程
refined nursing
heart valve replacement surgery
stress response
rehabilitation process
