探讨舒适护理对ERCP胆总管取石术患者护理质量影响

Effect of comfortable nursing on quality of care in patients undergoing endoscopic retrograde cholangiopancreatography

目的探讨舒适护理对行经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatograhy,ERCP)手术患者应用效果及影响.方法随机选取2014-06/2015-12入桐庐县第一人民医院行ERCP治疗的患者120例,分为实验组(行舒适护理,60例)和对照组(行常规护理,60例),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,采用单因素和多因素分析,探究两组患者护理质量差异性分析.结果经单因素和多因素分析,舒适护理方法对患者术前睡眠质量(RR=0.623,95%CI:0.412-0.924)、术中血压变化情况(RR=0.234,95%CI:0.134-0.524)、术中患者配合度(RR=0.423,95%CI:0.187-0.612)、术后睡眠质量(RR=0.435,95%CI:0.287-0.698)、术后擅自进食情况(RR=0.179,95%CI:0.024-0.798)均有影响,对术后出现胰腺炎无影响(RR=0.512,95%CI:0.136-1.524).结论舒适护理能显著提高ERCP患者术前睡眠质量,降低患者术中血压波动,增强患者术中与医生的配合度,提升了ERCP手术成功率及术后睡眠质量,降低患者术后擅自进食率,提高患者对医院的满意度等一系列良好效果.

AIM To evaluate the effect of comfort nursing on quality of care in patients undergoing endoscopic retrograde cholangiopancreatography（ERCP）.METHODS One hundred and twenty patients who underwent ERCP treatment from June 2014 to December2015 were randomly selected and divided into an experimental group（60 cases） to receive comfort nursing and a control group（60cases） to receive routine care. Univariate and multivariate analyses were used to explore the difference in the quality of care between the two groups.RESULTS Univariate and multivariate analyses demonstrated that comfort nursing had a significant effect on preoperative sleep quality（RR = 0.623, 95%CI：0.412-0.924）, intraoperative changes in blood pressure（RR = 0.234, 95%CI： 0.134-0.524）,degree of intraoperative patient compliance（RR = 0.423, 95%CI： 0.187-0.612）, postoperative sleep quality（RR = 0.435, 95%CI： 0.287-0.698）,and postoperative eating habits（RR = 0.179,95%CI： 0.024-0.798）, but had no effect on postoperative incidence of pancreatitis（RR =0.512, 95%CI： 0.136-1.524）.CONCLUSION Comfort nursing can significantly improve preoperative and postoperative sleep quality,reduce intraoperative fluctuations in blood pressure, improve intraoperative patient compliance to increase the success rate of surgery, improve postoperative eating habits,and increase patients＇ satisfaction in patients undergoing ERCP.