差异化分阶段护理管理对SCI患者神经源性肠功能障碍的临床效果

Clinical effect of individualized staged holistic nursing in spinal cord injury patients with neurogenic bowel dysfunction

目的:探讨差异化(个体化)分阶段护理管理对脊髓损伤(spinal cord injury,SCI)患者神经源性肠功能障碍的临床效果.方法:随机将我院收治的80例脊髓损伤后神经源性肠功能障碍(neurogenic bowel dysfunction,NBD)的患者分为实验组和对照组,对照组患者采取常规护理措施,实验组患者采取个体化分阶段护理管理,比较两组患者治疗前、急性期、住院康复期及出院随访期肠功能各项指标和生存质量评分情况.结果:两组患者各阶段肠功能均有不同程度改善,但实验组患者在急性期、住院康复期及出院随访期肠功能各项指标均明显优于对照组,差异具有显著性(P<0.05);对照组患者随访期肠功能有下降趋势;两组患者各阶段生存质量评分均有不同程度改善,在急性期及住院康复期实验组患者生存质量总分、生理领域得分、心理领域得分及环境领域得分均明显优于对照组,差异具有显著性(P<0.05),但两组患者社会领域得分差异无统计学意义(P>0.05);出院随访期实验组生存质量总分、生理领域得分、心理领域得分、社会领域得分及环境领域得分均明显优于对照组,差异具有显著性(P<0.05).结论:个体化分阶段护理管理能够明显改善患者肠道功能和生存质量,预后效果良好,患者满意度高,临床应用和推广价值较高.

AIM： To assess the clinical effect of individual- ized staged holistic nursing in spinal cord injury （SCI） patients with neurogenic bowel dysfunc- tion. METHODS： Eighty SCI patients with neurogenic bowel dysfunction were randomly divided into either an experimental or a control group. The control group was given routine nursing care, while the experimental group was given individ- ualized staged holistic nursing. Bowel function and the quality of life were compared between the two groups in different stages, including be- fore treatment, acute phase, rehabilitation phase, and follow-up phase. RESULTS： In different stages, the bowel func- tion was improved in varying degrees in the two groups. The improvement was more significant in the experimental group than in the control group in the acute phase, rehabilitation phase, and follow-up phase （all P 〈 0.05）. In the follow- up phase, the bowel function had a downward trend in the control group. The scores of quality of life were improved in varying degrees in the two groups; however, in the acute phase and re- habilitation phase, the experimental group was significantly better than the control group in terms of total score of life quality and scores for each of the domains of physiology, psychology, and environment （alI P 〈 0.05）, although there was no significant difference in the score for the social domain （P 〉 0.05）. In the follow-up phase, the experimental group was significantly better than the control group with regard to total score of life quality and scores for each of the domains of physiology, psychology, society, and environ- ment （all P 〈 0.05）. CONCLUSION： Individualized staged holistic nursing can help improve bowel function and quality of life in SCI patients with neurogenic bowel dysfunction.