临床护理路径在肾移植受者围术期的应用

Application of clinical nursing pathways in renal transplant recipients during the perioperative period

目的探讨临床护理路径（CNP）在肾移植受者围术期的应用效果。方法采用病例前后对照的研究方法，将60例肾移植受者按入院时间分为CNP组28例和对照组32例。CNP组肾移植受者围术期在整体护理基础上实施CNP护理，对照组采用常规的整体护理。比较两组的平均住院时间、平均住院费用、护理满意度及术后并发症的发生率，评价CNP实施效果。结果CNP组的平均住院时间为（27.6±4.3）d，低于对照组的（32.5±6.8）d,差异有统计学意义（t=-3.245，P=0.002）；CNP组的平均住院费用为（48621±10506）元，低于对照组的（54788±8521）元,差异有统计学意义（t=-2.509，P=0.015）。CNP组对护理满意、较满意和不满意的患者分别占67.9%，28.6%，3.6%；对照组对护理满意、较满意和不满意的患者分别占37.5%，43.8%，18.8%；CNP组的护理满意度优于对照组，差异有统计学意义（χ2=6.551，P=0.038）。而两组受者并发症发生率差异无统计学意义（P〉0.05）。结论肾移植受者围术期CNP护理模式科学、合理、操作性强，缩短了平均住院时间，降低了平均住院费用，提高了护理满意度，促进了护理质量的持续改进。

Objective To evaluate the effect of CNP （Clinical Nursing Pathways） on renal transplant recipients during the perioperative period. Methods 60 renal transplant recipients was divided into CNP group （28 cases） and control group （32 cases） according to their admission time, and the method of comparison was used. The control group only received conventional care while CNP group received CNP care in addition. Two group＇ s average length of stay, average hospitalization expense, satisfaction with the care and incidence rate of postoperative complication were compared during the perioperative period to evaluate the effect of CNP. Results The average length of stay of CNP group was （ 27.6 ± 4.3 ） d, shorter than （ 32.5 ± 6.8 ） d of the control group, and the difference was statistically significant （ t = - 3. 245, P = 0. 002 ）. The average hospitalization expense of CNP group was （ 48 621 ± 10 506 ） yuan, lower than （ 54 788 ± 8 521 ） yuan of the control group, and the difference was statistically significant （t = -2. 509 ,P = 0.015 ）. The rate of ＂satisfied＂, ＂less satisfied＂ and ＂not satisfied＂ of CNP group was 67.9%, 28.6% and 3.6% respectively, and that of the control group was 37.5% , 43.8% and 18.8% respectively. The satisfaction in the CNP group was better than that in the control group, and the difference was statistically significant （ χ2 = 6.551 ,P = 0. 038 ）. However, the difference between two group＇ s incidence rate of postoperative complication was not statistically significant （ P 〉 0.05 ）. Conduslons CNP nursing method for renal transplant recipients during the perioperative period is scientific, reasonable and feasible, which can shorten the length of stay, reduce average hospitalization expense, improve satisfaction with nursing and promote the continuous improvement of nursing quality.