整体护理对腹腔镜保胆取石患者睡眠和生活质量的影响

Effect of holistic nursing intervention on sleeping and quality of life in patients with laparoscopic gallbladder-preserving cholecystolithotomy

目的探讨整体护理对腹腔镜保胆取石患者睡眠和生活质量的影响。方法将110例胆囊结石患者随机分为对照组和观察组,各55例。2组均接受腹腔镜保胆取石术治疗,对照组实施常规外科护理,观察组实施整体护理干预。采用匹兹堡睡眠质量指数问卷(PSQI)评价患者干预前后睡眠质量,采用WHO生存质量量表(WHO QOL-BREF)评估生活质量,同时记录2组镇痛药的使用和并发症发生情况。结果干预后,2组PSQI总分均较干预前降低,WHO QOL-BREF总分均较干预前升高,差异有统计学意义(P<0.05或P<0.01)。干预后,观察组PSQI总分显著低于对照组(P<0.05),WHO QOLBREF量表生理功能、心理功能、环境领域和总分显著高于对照组(P<0.05或P<0.01)。观察组并发症发生率为5.45%,显著低于对照组的18.18%(P<0.05);观察组镇痛药使用率7.27%,显著低于对照组的21.82%(P<0.05)。结论对腹腔镜保胆取石患者实施整体护理,可降低并发症发生风险和减少镇痛药的使用,提高睡眠和生活质量。

Objective To investigate the effect of holistic nursing intervention on sleeping and quality of life in patients with laparoscopic gallbladder-preserving cholecystolithotomy. Methods A total of 110 patients with cholecystolithiasis were randomly divided into control group（ n = 55）and observation group（ n = 55）,both treated by laparoscopic gallbladder-preserving cholecystolithotomy. The control group was given conventional treatment and the observation group applied holistic nursing intervention. The Pittsburgh Sleep Quality Index（ PSQI） and WHO QOL-BREF scale were performed to all patients before and after intervention. The incidence of complication and analgesic usage were compared between two groups. Results The total PSQI scale scores was dropped and total QOL-BREF scale scores were increased in both groups after intervention（ P 〈 0. 05 or P 〈 0. 01）.Compared with the control group,the observation group had higher score in total PSQI and lower outcomes in physiological,mental,environmental dimensions and total QOL-BREF（ P 〈 0. 05 or P 〈0. 01）. The incidence of complication and analgesic usage rate were 5. 45% and 7. 27% in the observation group,and were 18. 18% and 21. 82% in the control group,with significant differences（ P 〈0. 05）. Conclusion Holistic nursing intervention is potentially effective in improving sleeping and quality of life in patients after laparoscopic gallbladder-preserving cholecystolithotomy,and it can also reduce the risk of complications and use of analgesic.