改良斜坡侧卧位配合穴位按摩对肝癌介入术后患者舒适度的影响

Effect of modified slope lateral position combined with acupoint massage on comfort after liver cancer intervention

目的探讨改良斜坡侧卧位配合穴位按摩对改善肝癌介入术后患者舒适度的影响.方法运用随机抽样法将100例原发性肝癌接受股动脉穿刺行肝动脉化疗栓塞术的患者分为对照组和观察组,各50例.对照组按介入科护理常规进行术前宣教及术后指导,术后患者采取传统平卧位,穿刺侧肢体伸直位制动8~12h;观察组除常规护理外,术后进行体位干预,运用改良斜坡侧卧位配合穴位按摩的方法来改善患者的舒适度.观察2组患者术前及术后24h的排尿情况、舒适度、腰背痛、下肢麻木及术后局部并发症的发生情况与护理满意度情况.结果观察组患者术后排尿障碍、腰背痛、下肢麻木、烦躁、失眠的发生率显著低于对照组(P<0.05);2组患者术后穿刺处出血和血肿的发生率无显著差异(P>0.05);观察组患者术后舒适度评分显著高于对照组,疼痛评分显著低于对照组(P<0.05);观察组护理满意度显著高于对照组(P<0.05).结论改良斜坡侧卧位配合穴位按摩能显著提高经股动脉穿刺肝癌介入术后患者的舒适度.

Objective To investigate the effect of modified slope lateral position combined with acupoint massage on improving the comfort of patients after liver cancer intervention. Methods A total of 100 patients with primary hepatic carcinoma undergoing transcatheter arterial chemoembolization (TACE) admitted to our department were divided into control group and observation group by random sampling method. The control group( n =50) underwent preoperative education and postoperative guidance. After operation, patients were in a conventional supine position, and the puncture side limbs were stretched and maintained for 8 to 12 hours. In addition to routine nursing, the observation group was given postoperative positional intervention, the modified slope lateral position combined with acupoint massage was used to improve patients′ comfort. The urination, comfort, low back pain, lower extremity numbness and postoperative local complications and nursing satisfaction were compared between the two groups before and at 24 h after surgery. Results The observation group had lower incidence of postoperative dysuria, low back pain, lower limb numbness, irritability and insomnia than that in the control group( P <0.05). There were no significant differences in postoperative bleeding and hematoma at the puncture sites( P >0.05). The postoperative comfort scores and satisfaction in the observation group were higher, and the pain score was lower than that of control group( P <0.05). Conclusion Modified slope lateral position combined with acupoint massage can significantly improve the comfort of liver cancer patients with transfemoral intervention.