专科护理制在肾移植术后ICU中的应用

Application of Specialized Nursing in Post-renal Transplantation Intensive Care Unit

目的总结分析专科护理制在肾移植术后ICU的实施效果。方法收集汇总本院2005年1—12月367例肾移植患者临床及随访资料,按护理方式不同分为三组:普通病房组(94例)、单纯隔离组(121例)和ICU专科护理组(152例)。比较三组患者在短期并发症发生率、心理状况、满意度、远期生存率方面有无差异。结果 ICU专科护理组短期并发症发生率明显低于普通病房组和单纯隔离组(P<0.05);ICU专科护理组和单纯隔离组术后抑郁和焦虑的发生率高于普通病房组(P<0.05);ICU专科护理组的患者满意度高于普通病房组和单纯隔离组(P<0.05);ICU专科护理组的三年移植肾生存率高于普通病房组(P<0.05),五年移植肾生存率高于普通病房组和单纯隔离组(P<0.05)。结论 ICU专科护理制能降低患者的短期并发症,提高患者的满意度和移植肾的远期生存率;ICU专科护理应注意患者的心理护理。

Objective To summarize and analyze the effect of specialized nursing in post-renal transplantation intensive care unit（ ICU）. Methods The clinical records and follow-up data of patients who had undergone the renal transplantation were retrospectively collected from January,2005 to December,2015. These patients were categorized into three groups,according to the types of nursing： specialized nursing group（ n = 94）,ICU without specialized nursing group（ n = 121） and intensive care unit（ ICU） with specialized nursing group（ n = 152）.The short-term postoperative morbidity rate,psychological status,satisfaction and long-term survival rate were compared between these groups. Results The short-term postoperative morbidity rate in ICU with specialized nursing group was significantly lower than those in general nursing group and ICU without specialized nursing group（ P〈 0.05）. The occurrence of depression and anxiety in patients was more common in general nursing group than the other two groups. The satisfaction was highest in ICU with specialized nursing group. Three-year survival rates of renal grafts in ICU with or without specialized care group were higher than general nursing group,and five-year survival rate of renal grafts was highest in ICU with specialized care group. Conclusion The application of specialized nursing in post-renal transplantation ICU could significantly reduce short-term postoperative morbidity and improve the patient satisfaction as well as the long-term renal grafts survival rate. However,additional efforts on psychological counseling should be made during the stay in ICU.