胸腔闭式引流患者应用集束化护理的效果研究

Study on the application effects of bundle nursing intervention for patients with thoracic closed drainage

目的观察集束化护理对胸腔闭式引流患者的应用效果。方法将260例行胸腔闭式引流的患者随机分为观察组和对照组,每组130例,对照组采用常规护理方法,观察组行集束化护理。比较两组患者疼痛主诉分级法(VRS)评分、匹兹堡睡眠质量指数(PSQI)评分、负性情绪评估症状自评量表(SCL-90)评分、舒适度分级评分及胸腔闭式引流的并发症等。结果观察组患者VRS评分、PSQI评分、SCL-90评分及舒适度分级评分均优于对照组,差异有统计学意义(P<0.01),并发症(复张性肺水肿、引流管脱落、引流管阻塞、皮下气肿及胸腔感染)的发生率均显著低于对照组(P<0.05)。结论集束化护理可改善患者负性心理状态,减轻术后心理和身体痛苦,提高患者舒适度,还可降低胸腔闭式引流的并发症,从而提高疗效及医疗服务质量。

Objective To study the application effects of bundle nursing intervention for patients with thoracic closed drainages. Methods 260 patients with closed drainage were randomly divided into study group and control group with 130 cases in each. patients in control group received conventional nursing intervention, while patients in the study group were treated by bundle nursing intervention. Two group of patients were assessed with verbal rating scale（VRS）, pittsburg sleep quality index（ PSQI）, symptom check list-90 （SCL-90） and comfort scale, the complication of thoracic closed drainage were also observed and compared between two groups. Results The assessed scores of VRS, PSQI,SCL-90 and comfort scale in study group were more satisfactory than those in control group. There were significant differences between two groups（P〈0.01）. The complications of thoracic closed drainage （re-expansion pulmonary edema, the shedding of drainage-tube, the obstruction of drainage-tube, subcutaneous emphysema and the thoracic cavity infection） in study group were significantly lower than those in control group（P〈0.05）. Conclusion The bundle nursing intervention can decrease the patients negative emotion, relieve the patients＇ psychological and physical pain, promote the comfortable degree and reduce the complication of thoracic closed drainage, then improve the clinic effect as well as the quality of medical service.