循证护理模式在高龄下肢动脉硬化患者中的效果

Effect of evidence-based nursing in elderly patients with lower limb arteriosclerosis

目的探讨循证护理模式对高龄下肢动脉硬化患者的护理效果。方法选取2009年3月至2012年5月在解放军总医院住院的高龄下肢动脉硬化患者260例,男性184例,女性76例,年龄80~97岁。所有患者随机分为2组,对照组（108例）和循证组（152例）。对照组采用常规护理方法,循证组从合理饮食、改善生活习惯、增强遵医行为等方面进行循证护理。4周时比较两组对疾病认知较好、体重控制较好、生活习惯较好、心理状况较好、遵医行为较好比例及血脂水平。结果对照组与循证组采用不同护理模式4周后,与对照组比较,循证组体重控制较好的比例（5.6%vs.20.7%）、生活习惯较好的比例（3.7%vs.31.0%）、遵医行为较好的比例（11.1%vs.41.4%）、心理状况较好的比例（3.7%vs.32.8%）增加,差异具有显著统计学意义（P均〈0.01）;对疾病认知较好的比例（0%vs.6.9%）增加,差异具有统计学意义（P〈0.05）。4周后循证组三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平优于对照组,差异有统计学意义（P均〈0.05）;总胆固醇较对照组无明显变化,差异无统计学意义（P〉0.05）。结论循证护理模式通过查阅资料,针对疾病相关危险因素采取相应护理措施,改善了高龄下肢动脉硬化患者血脂水平和疾病认知、生活习惯、遵医行为等。

Objective To investigate the effect of evidence-based nursing in elderly patients with lower limb arteriosclerosis. Methods The patients （n=260, male 184, female 76 and aged from 80 to 97） were chosen from Mar. 2009 to May 2012, and then randomly divided into control group （n=108） and evidence-based nursing group （n=152）. The control group was given routine nursing and evidence-based nursing group was given evidence-based nursing from the aspects of reasonable diet, lifestyle and compliance reinforcement. The percentage of patients with higher disease cognition and weight control, and better lifestyle, psychological status and compliance, and blood fat level were compared between 2 groups after 4 w. Results Compared with control group, the percentage of patients with higher weight control （5.6% vs. 20.7%）, better lifestyle （3.7% vs. 31.0%）, better compliance （11. 1% vs. 41.4%） and better psychological status （3.7% vs. 32.8%） increased in evidence-based nursing group （all P〈0.01） after 4 w. Compared with control group, the percentage of patients with higher disease cognition （0% vs. 6.9%） increased in evidence-based nursing group （P〈0.05）. The changes of levels of TG, LDL-C and HDL-C were superior in evidence-based nursing group to those in control group （all P〈0.05）, and TC level had no significant changes compared with control group （P〉0.05）. Conclusion The mode of evidence-based nursing reduces blood fat level, and improves disease cognition, lifestyle and compliance in elderly patients with lower limb arteriosclerosis.