Orem自理模式在食管支架置入术并食管狭窄扩张术术后患者饮食中的应用研究

Study on Orem self-care mode applied in postoperative diet of patients with esophageal stent implantation and esophageal stricture dilatation

目的探讨奥瑞姆(Orem)自理模式在内镜下食管支架置入术并食管狭窄扩张术术后的饮食护理有效性。方法 100例中晚期食管癌患者,随机分成观察组和对照组,各100例。对照组患者采用传统的饮食护理方式,观察组患者给予Orem自理模式的指导和护理干预。评估两组患者的自理能力等指标。结果观察组患者中完全自理20例,部分自理26例,不能自理4例;对照组患者完全自理10例,部分自理24例,不能自理16例;观察组患者自理能力优于对照组,差异有统计学意义(P<0.05)。护理后,观察组未见食管支架脱落和食物梗阻的患者,对照组食管支架移位脱落5例,食物梗阻3例,并发生症发生率为16.0%;两组并发生症发生率比较差异有统计学意义(P<0.05)。术前两组血清白蛋白、前白蛋白、体重指标比较差异无统计学意义(P>0.05);术后观察组血清白蛋白、前白蛋白、体重指标优于对照组,差异有统计学意义(P<0.05)。结论 Orem自理护理模式可以帮助患者尽快满足自理需要,完善自我照顾进程,明显改善患者的营养状况,避免焦虑不安情绪,使术后并发症的发生率降低最低,减少了患者的痛苦,延长了患者的生命,提高了患者疾病晚期生存质量,为家庭和社会减轻了负担。

Objective To explore the efficiency of Orem self-care mode in postoperative diet of patients with esophageal stent implantation and esophageal stricture dilatation. Methods A total of 100 middle and advanced esophageal carcinoma patients were randomly divided into observation group and control group, with 50 cases in each group. The control group received traditional diet nursing method, and the observation group received Orem self-care mode guidance and nursing intervention. Self-care ability was evaluated in two groups. Results The observation group had 20 complete self-care cases, 26 partial self-care cases, and 4 unable selfcare cases, while the control group had 10 complete self-care cases, 24 partial self-care cases, and 16 unable self-care cases. The observation group had better self-care ability than the control group, and the difference had statistical significance（P〈0.05）. After nursing, the obsrvation group had 0 esophageal stents falling off and food obstruction cases, while the control group had 5 esophageal stents displacement and falling off cases and 3 food obstruction cases, with incidence of complications as 16.0%. There was no statistically significant difference in incidence of complications between two groups（P〈0.05）. Both groups had no statistically significant difference in serum albumin, prealbumin and weight index before treatment（P〉0.05）. The observation group had better serum albumin, prealbumin and weight index after treatment than the control group, and the difference had statistical significance（P〈0.05）. Conclusion Orem self-care nursing mode can meet the needs of self-care in patients as soon as possible, complete self-care process, obviously improve nutritional status of patients, avoid anxietyemotion, decrease incidence of postoperative complications to a minimum, reduce the patient＇s pain, extend lives of patients, improve the quality of life for patients with advanced disease, along with relief of family and social burden.