四全照顾在老年中高危腹主动脉瘤腔内修复术治疗中的应用效果

Application of Holistic Care in Older Patients Undergoing the Endovascular Repair for High Risk Abdominal Aortic Aneurysm

目的探究四全照顾在老年中高危腹主动脉瘤腔内修复术治疗中的应用效果。方法选取2017年1月~2018年4月于哈尔滨医科大学附属第一医院接受腔内修复术治疗的142例中高危腹主动脉瘤老年患者为研究对象,按照随机数表法将患者分为对照组与观察组各71例。对照组采取常规照顾护理方案,观察组在对照组的基础上加以四全照顾护理方式。比较两组术后拔气管插管时间、ICU观察时间、术后进食时间以及总住院时间等术后指标;比较两组焦虑自评量表(SAS)、抑郁自评量表(SDS)、Kolcaba舒适度评分(GCQ)以及Barthel自理指数;比较两组患者并发症发生情况。结果观察组术后拔气管插管时间、ICU观察时间、术后进食时间以及总住院时间均短于对照组,差异均具有统计学意义(P<0.001);治疗后观察组SAS评分、SDS评分均低于对照组,GCQ评分与Barthel自理指数均高于对照组,差异均具有统计学意义(P<0.001);观察组并发症发生率低于对照组,差异具有统计学意义(P<0.05)。结论四全照顾应用于腔内修复术有利于提高中高危腹主动脉瘤老年患者手术效果,降低患者住院时间和并发症发生率,对于患者情绪控制以及自理能力有促进作用。

Objective To assess the application of holistic care in older patients undergoing the endovascular repair for high risk abdominal aortic aneurysm.Methods A total of 142 older patients with moderate to high risk abdominal aortic aneurysm who underwent endovascular repair were enrolled in the First Affiliated Hospital of Harbin Medical University from January 2017 to April 2018.The patients were divided into the control group(71 cases)and the observation group(71 cases)according to the random number table.The control group received the routine care.The observation group received the holistic care.The tracheal extubation time,ICU observation time,eating time and total hospitalization time were documented after surgery.The self-rating anxiety scale(SAS),self-rating depression scale(SDS),Kolcaba general comfort questionnaire(GCQ)and Barthel index of ADL were assessed.The complications were recorded.Results The postoperative tracheal extubation time,ICU observation time,postoperative eating time and total hospitalization time in the observation group were shorter than those in the control group(P<0.001).After treatment,the SAS score and SDS score were lower,GCQ score and Barthel index were higher in the observation group than those in the control group(P<0.001).The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion The application of holistic care might be beneficial to improve the surgical outcome of older patients undergoing endovascular repair for moderate and high risk abdominal aortic aneurysm,reduce the hospitalization time and the incidence of complications,and improve the patient's emotional control and self-care ability.