舒适护理在胆石症逆行胰胆管造影围手术期运用效果

Perioperative application of comfort nursing in patients with gallstone disease undergoing endoscopic retrograde pancreatic duct radiography

目的:分析舒适护理在胆石症逆行胰胆管造影围手术期应用的效果及其影响因素,进而探讨舒适护理对患者护理质量的影响.方法:选取2015-01/12杭州市萧山区第一人民医院住院并行内镜逆行胰胆管造影手术168例患者,排除高血压等慢性基础疾病、胰腺炎患者.将患者按照入院时间随机分为两组;干预组106例采用舒适护理管理模式,对照组62例采用常规护理管理模式.两组患者分别入住不同病房区,以进行针对性的护理,避免因护理模式不同而造成的沾染影响.采用统计学软件SPSS20.0对比分析不同护理方式下患者术前睡眠质量、术中血压异常、中止情况及手术配合度、术后发生胰腺炎、术后擅自进食及身体恢复情况、住院满意度等因素的差异性,采用?2进行组间差异比较分析,并对舒适护理的相关影响因素作Logistic回归分析,找到其独立作用因素.结果:本次研究对象中干预组106例实施舒适护理、对照组62例实施常规护理,两组患者在性别、年龄、文化程度及职业构成等方面均无显著差异(P>0.05),具有可比性;舒适护理组患者术前睡眠欠佳发生率、术中血压异常波动、术中手术不配合、术中终止、术后睡眠欠佳、术后擅自进食、住院不满意等因素与常规护理组比较,均有显著改善,但尚不能认为舒适护理对胆石症逆行胰胆管造影患者术后恢复良好、术后发生胰腺炎有影响;舒适护理对患者术前睡眠、术中血压情况、术中配合情况、术中终止情况、术后睡眠情况、术后擅自进食及住院满意度等有独立作用.结论:对患者采用舒适护理,术前:稳定情绪、提高睡眠质量.术中:稳定血压、降低手术中止率、提高配合度.术后:改善睡眠、减少擅自进食、提高住院满意度.但不能确定舒适护理对术后恢复情况、术后胰腺炎发生率存在影响.

AIM：To evaluate the efficacy of perioperative application of comfort nursing in patients with gallstone disease undergoing endoscopic retrograde cholangio-pancreatography（ERCP）,influencing factors,and the impact on the quality of nursing care.METHODS：From January 2015 to December2015,168 patients who underwent ERCP were randomly divided into two groups according to the time of admission.An intervention group（n = 106） received comfort nursing,and a control group（n = 62） received routine nursing.Sleep quality,intraoperative abnormal fluctuation of blood pressure,intraoperative suspension,postoperative food intake without permission,patient satisfaction,postoperative recovery,and postoperative incidence of pancreatitis were compared between the two groups.Logistic regression analysis was used to identify independent factors related to comfort nursing.RESULTS：There was no significant difference in gender,age,educational level or occupation between the two groups（P0.05）.Sleep quality,intraoperative abnormal fluctuation of blood pressure,intraoperative suspension,postoperative food intake without permission,and patient satisfaction were significantly improved in the intervention group compared with the control group,but postoperative recovery and postoperative pancreatitis showed no significant difference between the two groups.Sleep quality,intraoperative abnormal fluctuation of blood pressure,intraoperative suspension,postoperative food intake without permission,and patient satisfaction were factors independently associated with comfort nursing.CONCLUSION：Comfort nursing can improve sleep quality and patient＇s mood fluctuation,reduce the consumption of food without permission,and improve patient satisfaction in patients with gallstone disease undergoing ERCP.