护理干预对结核性胸膜炎患者中心静脉导管胸腔引流效果及治疗依从性的影响

Effect of nursing intervention on pleural drainage and treatment compliance for central venous catheter patients with tuberculous pleurisy

目的探讨护理干预对结核性胸膜炎患者中心静脉导管胸腔引流的效果及其对抗结核治疗依从性的影响。方法将72例接受中心静脉导管胸腔引流的结核性胸膜炎患者随机分为干预组和对照组,实施不同的护理措施,观察两组胸腔引流的效果及其抗结核治疗的依从性。结果干预组一次性置管成功率92.1%(35/38);置管引流后,平均胸水消失时间(4.0±1.2)d,总住院天数(14.6±3.3)d;上述指标和对照组比较差异均有统计学意义(P<0.05或0.01)。出院时,干预组知识达标32例(84.2%,32/38),患者满意度评分(92.5±4.2)分,上述指标和对照组比较差异均有统计学意义(P<0.001)。服药依从性评估显示,干预组依从性高者达到50.0%(10/38),两组服药依从性比较差异有统计学意义(P<0.05)。结论对实施中心静脉导管胸腔引流的结核性胸膜炎患者进行综合护理干预,能改善胸腔引流效果,提高患者治疗依从性,有利于从根本上提高抗痨治疗的效果。

Objective To investigate the effect of nursing intervention on pleural drainage and anti-tuberculosis treatment compliance for central venous catheter patients with tuberculous pleurisy. Methods Seventy-two cases of tuberculous pleurisy patients who underwent central venous catheter drainage were randomly assigned into intervention group and control group. In two groups different nursing measures were adopted,and thoracic drainage effect and anti-tuberculosis treatment compliance were observed. Results In intervention group,the success rate of catheter insertion was 92. 1%（ 35 /38） with 4 cases of adverse reactions（ 10. 5%,4 /38）; the average disappearance time of hydrothorax was（ 4. 0 ± 1. 2） d with（ 14. 6 ± 3. 3） d of total hospital stay length; except for the adverse reactions after catheter insertion,the other indicators related to drainage were significantly different from those in the control group（ P〈0. 05 or0. 01）. The results of an survey on patients＇ tuberculosis prevention knowledge and nursing satisfaction indicated that 32 cases reached the standard of patients＇ health knowledge in the intervention group（ 84. 2%,32 /38）,and patient satisfaction scores reached（ 92. 5 ±4. 2）. Compared with the indexes in the control group,the differences were statistically significant（ P〈 0. 001）. Compliance assessment showed that high compliance rate of intervention group reached 50. 0%（ 10 /38）,significantly different from that of the control group（ P〈0. 05）. Conclusions Implementing nursing intervention from the aspects of cognition,psychology,diet and medication for central venous catheter drainage patients with tuberculous pleurisy has significant effect on improving the drainage effect and polishing up the treatment compliance,which can availably improve the curative effect of tuberculous pleurisy fundamentally.