心理干预结合精细化护理在多切口肛瘘术后护理中的应用

Application of psychological intervention combined with refined nursing in postoperative nursing of multi-incision anal fistula

目的 研究心理干预结合精细化护理在多切口肛瘘术后护理中的应用效果。方法 本研究对象为2021年7月至2022年9月于常州市中医医院肛肠科行多切口肛瘘术的126例患者,将全部病例使用随机数字表法划分为对照组和观察组,每组63例。对照组患者在住院期间给予常规护理,观察组患者在住院期间给予心理干预结合精细化护理。对比2组患者在干预前后的疼痛状况、术后恢复速度、心理水平以及术后并发症发生情况。结果 术后第1天,2组的视觉模拟评分法(VAS)评分无统计学差异(P>0.05);术后第3天及出院时,观察组的VAS评分均明显低于同期对照组(P均<0.05)。观察组的住院时间和创面愈合时间均明显短于对照组(P均<0.05)。术后第1天,2组的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均无统计学差异(P均>0.05);术后第3天及出院时,观察组的SAS和SDS评分均明显低于同期对照组(P均<0.05)。观察组患者在术后发生尿潴留、切口感染、出血和直肠脱垂的并发症总发生率低于对照组(P<0.05)。结论 行多切口肛瘘术的患者在术后接受心理干预结合精细化护理,可以明显加快其康复速度,降低术后疼痛程度和并发症发生率,提高其术后心理健康水平。

Objective To explore the application effect of psychological intervention combined with refined nursing in postoperative nursing of multi-incision anal fistula.Methods The subjects of this study were 126 patients who underwent multi-incision anal fistula surgery at the Proctology Department of Changzhou Hospital of Traditional Chinese Medicine from July 2021 to September 2022.All patients were randomly divided into a control group and an observation group using a random number table method,with 63 patients in each group.The control group received routine nursing during hospitalization,while the observation group received psychological intervention combined with refined nursing during hospitalization.The pain status,postoperative recovery speed,psychological level and postoperative complications of the two groups were compared before and after intervention.Results On the first day after surgery,there was no statistically significant difference in Visual Analogue Scale(VAS)scores between the two groups(P>0.05).On the 3rd day after surgery and at discharge,the VAS scores of the observed group were obviously less than those of the control group during the same period(both P<0.05).The hospitalization time and wound healing time of the observed group were obviously less than those of the control group(all P<0.05).On the first day after surgery,there was no statistically significant difference in the scores of Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)between the two groups(both P>0.05).On the third day after surgery and at discharge,the SAS and SDS scores of the observed group were obviously less than those of the control group during the same period(all P<0.05).The total incidence of postoperative complications of urinary retention,incision infection,bleeding and rectal prolapse in the observed group was less than that in the control group(P<0.05)Conclusion Psychological intervention combined with refined nursing can significantly accelerate the recovery speed,reduce the degree of postoperative pain and the incidence of complications,and improve the postoperative mental health level for patients undergoing multi-incision anal fistula surgery.