15例肠结核并发不完全性肠梗阻患者的整体护理效果评价

Evaluation of holistic nursing care for 15 patients with intestinal tuberculosis complicated with incomplete intestinal obstruction

目的 探讨整体护理理念下对肠结核并发不完全性肠梗阻患者实施综合护理的方法、途径及其效果。方法搜集2014年5月至2015年11月安徽省胸科医院内一科四病区收治的肠结核并发不完全性肠梗阻患者15例，确立以患者为中心的整体护理理念，采用常规基础护理、用药护理、胃肠减压护理、纠正水电解质酸碱失衡的护理、热敷和按摩护理、灌肠护理、饮食护理、生活护理、心理护理、出院指导和消毒隔离知识宣传教育等多种护理方法和护理内容，观察并记录患者临床症状的改变及并发症的情况；并自制《护理满意度调查表》（简称“调查表”），包括护理工作人员对患者的情感态度、工作责任心、操作熟练度、患者接受服务后的舒适度4个方面内容，以评价患者对护理治疗的满意度，调查表于患者出院前1天发放，出院时采用单盲法回收（将填写好的调查问卷以不记名的方式放到护士站的特定小筐内）。结果15例患者经整体护理后腹胀、腹痛消失时间为3～5d、康复时间为24-33d；患者住院期间口腔感染率、肺部感染率及尿路感染率均为0．0％；出院后随访6个月或超过1年，肠梗阻复发率为0．0％，规范抗结核治疗率100．0％。统计调查表，患者对护理的人均满意度得分为98．4分（满分100分）。结论对肠结核并发不完全性肠梗阻患者施以整体护理理念下的综合护理，对患者临床症状的缓解、缩短疾病的康复时间、降低与避免并发症的产生，以及提高患者对护理情况的满意度均达到了较好的效果。

Objective To explore the method and effect of holistic nursing for intestinal tuberculosis complicated with intestinal obstruction. Methods Changes of clinical symptoms and complications of 15 intestinal tuberculosis patients complicated with incomplete intestinal obstruction from Ward 4, Department of Medieine, Anhui Chest Hospital between May 2014 and November 2015, who undergoing holistie nursing care, including conventional basic nursing, medication nursing, gastrointestinal decompression, correcting imbalance of water and electrolyte acid-base, hot compress and massage, enema nursing, diet nursing, life care, psychological care, guidance and health education and so on, were recorded. The nursing satisfaction questionnaire （short for questionnaire）, including nursing staff＇s attitude to patients, responsibility, skill, comfort of patient after receiving service, was used to evaluate that if patients were satisfactory with the nursing care. The questionnaire would be given to patients one day before they leave hospital and called in using single blind method （put the questionnaire into a special small basket in the nurse station） when patients leave hospital. Results After treated with holistic nursing, abdominal pain of all the 15 patients disappeared 3-5 days later and they recovered 24-33 days later. When during the rates of oral infection, lung infection and urinary tract infection were all 0 in hospitalized patients; there is no obstruction re currence and all the patients got standard anti-tuberculosis treatment during 6 months or over 1 year follow-up after leaving hospital. The average score of patients satisfaction with nursing care is 98.4 （the full mark is 100）. Cenclusion Holistic nursing care for 15 patients with intestinal tuberculosis complicated with incomplete intestinal obstruction helps to relieve clinical symptoms, shorten recovery duration, reduce and avoid complications, and improve patients satisfactory with the nursing care.