舒适护理联合临床护理路径对子宫肌瘤切除术患者术前焦虑及手术应激及术后心身舒适度的影响

Effect of comfortable nursing combined with clinical nursing pathway on preoperative anxiety,surgical stress and postoperative psychosomatic comfort in patients undergoing myomectomy

目的探讨舒适护理联合临床护理路径对子宫肌瘤切除术患者术前焦虑、手术应激及术后心身舒适度的影响。方法选取2015年5月至2017年6月间雅安市人民医院收治的92例子宫肌瘤切除术患者,根据护理方式不同分为观察组和对照组,每组46例。观察组患者采用舒适护理联合临床护理路径护理,对照组患者采用临床护理路径护理。比较两组患者手术前后负性情绪、舒适度相关指标情况和T1(术前1d)、T2(气腹后10min)、T3(手术结束后)时刻的呼吸(R)、心率(HR)、血压(BP)及血氧饱和度(Sp O2)等指标变化。结果观察组患者环境、术后疼痛、体位、排泄及心理等舒适度均优于对照组,差异均有统计学意义(均P<0.05)。两组患者术前焦虑自评量表(SAS)和抑郁自评量表(SDS)评分比较,差异无统计学意义(P>0.05);术后,两组患者SAS和SDS评分均较术前降低,且观察组患者均较对照组下降明显,差异均有统计学意义(均P<0.05)。两组患者T1时刻R、HR、BP和Sp O2比较,差异均无统计学意义(P>0.05);观察组患者T1、T2和T3时刻R、HR和BP比较,差异均无统计学意义(P>0.05);对照组患者T2和T3时刻R、HR、BP与T1比较,差异均有统计学意义(均P<0.05);两组患者任意时刻Sp O2比较,差异均无统计学意义(P>0.05),表明观察组患者各方面更为稳定,应激能力更强。结论在子宫肌瘤切除术患者中采用舒适护理联合临床护理路径护理,可有效改善患者术前焦虑,提高心身舒适度,降低手术应激反应,值得临床推广。

Objective To investigate the effect of comfort nursing combined with clinical nursing pathway on preoperative anxiety,surgical stress and postoperative psychosomatic comfort in patients undergoing myomectomy. Methods The clinical data of 92 patients who underwent hysteromyomectomy at Ya＇an People＇s Hospital from May 2015 to June 2017 were analyzed retrospectively. They were divided into an observation group and a control group witth 46 patients in each group according to the different nursing methods. The observation group was given comfort nursing combined with clinical nursing pathway-guided nursing and the control group was given clinical nursing pathway-guided nursing. The changes in self-rating anxiety scale（ SAS） and self-rating depression scale（ SDS） scores,comfort-related indexes and breathing（ R）,heart rate（ HR）,blood pressure（ BP） and blood oxygen saturation（ Sp O2） at T1（ 1 d before the surgery）,T2（ 10 min after pneumoperitoneum） and T3（ at the end of the surgery）. Results The comfort of environment,postoperative pain,posture,drainage and psychology were better in the observation group than in the control group（ P〈0. 05）. There was no significant difference in preoperative SAS and SDS scores between the two groups（ P〉0. 05）. SAS and SDS scores decreased in the two groups compared with before operation with the decrease significantly obvious in the observation group than in the control group（ P〈0. 05）. There was no significant difference in R,HR,BP and Sp O2 between the two groups at T1（ P〉0. 05）. There was no significant difference in R,HR and BP at T1 in the observation group（ P〉0. 05） but there was significant difference in R,HR and BP between T2 and T3 and T1 in the control group（ P〈0. 05）. No significant difference in Sp O2 was noted between the two groups at any time point（ P〉0. 05）indicating that the observation group was more stable and more stressed in several aspects. Conclusion Comfort nursing combined with clinical nursing pathway can effectively reduce preoperative anxiety,improve physical and psychological comfort and reduce the stress reaction to surgery in patients undergoing myomectomy. It is worthy of clinical promotion.