综合护理干预在高龄胆石症患者围术期的应用效果

Effect of comprehensive nursing intervention on perioperative period of elderly patients with cholelithiasis

目的探讨综合护理干预在高龄胆石症患者围术期的应用效果。方法选取2015年1月~2018年12月我院收治的100例高龄胆石症患者作为研究对象,根据随机数字表法分为对照组和研究组,每组各50例。对照组采用常规围术期护理方法,研究组采用围术期综合护理干预。比较两组手术相关指标,包括心率(HR)、呼吸频率(RR)、动脉血氧分压(PaO2)、住院时间、术中出血量、手术时间、排气时间;两组护理前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分;两组术后并发症发生情况,包括切口感染、胃酸反流、胆管出血;两组临床护理满意度。结果研究组的HR为(84.50±8.30)次/min,RR为(23.40±6.35)次/min,均低于对照组[(106.60±9.95)次/min、(34.95±7.95)次/min],术中出血量为(16.80±5.10)ml,少于对照组Ⅰ(29.95±6.40)ml](P<0.05);研究组的PaO2为(85.75±5.60)mmHg,高于对照组[(72.50±9.35)mmHg](P<0.05);研究组的住院时间为(6.40±0.50)d,手术时间为(44.50±10.50)min,排气时间为(10.30±3.70)h,均短于对照组[(9.40±1.35)d、(56.45±11.65)min、(16.70±4.35)h](P<0.05);研究组护理后的SAS评分为(37.10±1.25)分,SDS评分为(38.30±1.10)分,均低于对照组[(47.30±1.40)、(48.40±1.35)分](P<0.05);研究组术后并发症总发生率为4.00%,低于对照组的24.00%(P<0.05);研究组临床护理总满意度为96.00%,高于对照组的74.00%(P<0.05)。结论实施围术期综合护理干预可明显提高高龄胆石症患者的护理效果。

Objective To explore the effect of comprehensive nursing intervention in elderly patients with cholelithiasis during perioperative period.Methods From January 2015 to December 2018,100 elderly patients with gallstones treated in our hospital were selected and divided into control group(n=50)and study group(n=50)according to random number table method.The control group was treated with routine perioperative nursing method,and the study group was treated with perioperative comprehensive nursing intervention.The related indexes of operation were compared between the two groups,including heart rate(HR),respiratory frequency(RR),arterial partial pressure of oxygen(PaO2),hospitalization time,intraoperative bleeding volume,operation time and exhaust time.The scores of self-rating anxiety scale(self-rating anxiety scale,SAS)and self-rating depression scale(self-rating depression scale,SDS)before and after nursing were evaluated in the two groups.Postoperative complications occurred in the two groups,including incision infection,gastric acid reflux,bile duct bleeding,and clinical nursing total satisfaction.Results The HR of the study group was(84.50±8.30)times/min,RR was(23.40±6.35)times/min,the intraoperative bleeding volume was(16.80±5.10)ml,which was lower than that of the control group([106.60±9.95]times/min,[34.95±7.95]times/min,[29.95±6.40]ml).The PaO2 of the study group was(85.75±5.60)mmHg,which was higher than that of the control group([72.50±9.35]mmHg).The duration of stay in the study group was(6.40±0.50)d,the operation time was(44.50±10.50)min,and the exhaust time was(10.30±3.70)h,which were shorter than that of the control group([9.40±1.35]d,[56.45±11.65]min,[16.70±4.35]h)(P<0.05).The SAS and SDS score of the study group were(37.10±1.25)and(38.30±1.10),respectively,which were lower than those of the control group([47.30±1.40],[48.40±1.35]).The total postoperative complications in the study group were 4.00%,which were lower than those in the control group(24.00%)(P<0.05).The total satisfaction of clinical nursing in the study group was 96.00%,which was higher than that in the control group(74.00%)(P<0.05).Conclusion Peri-operative comprehensive nursing intervention can significantly improve the nursing effect of elderly patients with cholelithiasis.