临床护理路径在主动脉夹层Stanford B型腔内修复术后运用效果研究

Study on the Application Effect of Clinical Nursing Path after Stanford B-type Endovascular Repair of Aortic Dissection

目的将临床护理路径应用于主动脉夹层Stanford B型腔内修复术后的效果进行探究。方法选取2017年7月—2019年10月期间该院收治的主动脉夹层Stanford B型并行EVAR术治疗患者96例,按照单盲法抽签将样本分为两组,临床路径组(n=42)和非临床路径组(n=45),非临床路径组实施术后常规护理,临床路径组实施护理临床路径,比较两组患者并发症发生率和护理前后临床指标的变化情况。结果两组患者并发症发生率比较差异无统计学意义(P>0.05);实施路径的患者在活动前后的心率、平均动脉压差异无统计学意义(P>0.05);两组并发症发生率、伤口渗血发生率及不适发生率差异无统计学意义(P>0.05),但在术后24 h舒适度(4.00±0.77)分和住院天数(7.83±1.46)d均优于非临床路径组,差异有统计学意义(t=15.11、7.331,P<0.05)。结论实施临床护理路径可以有效提升患者的舒适度,并缩短其住院时间,且不会对患者的心率、动脉压造成影响,也不会引起并发症数量的增多,安全性较高,具有推广价值。

Objective To explore the effect of clinical nursing path applied to Stanford B-type endovascular repair of aortic dissection. Methods From July 2017 to October 2019, selected 96 patients with Stanford B-type aortic dissection and EVAR treated in this hospital. The samples were divided into two groups according to the single-blind method, the clinical pathway group(n=42) and the non-clinical pathway group(n=45), the non-clinical pathway group received routine postoperative care, and the clinical pathway group implemented clinical care pathways. The incidence of complications and changes in clinical indicators before and after nursing were compared between the two groups.Results There was no statistically significant difference in the incidence of complications between the two groups of patients(P >0.05);there was no statistical difference in the heart rate, mean arterial pressure Before and after the exercise for patients who implemented the route(P >0.05);there was no statistically significant difference in the incidence of complications, incidence of wound bleeding, and incidence of discomfort between the two groups(P>0.05),but the 24 h postoperative comfort(4.00±0.77)points and hospital stay(7.83±1.46) d were better than those in the nonclinical pathway group,the difference was statistically significant(t =15.111, 7.331, P <0.05). Conclusion The implementation of clinical care pathway can effectively improve the comfort of patients and shorten their hospitalization time, without affecting the heart rate and arterial pressure of the patients, and will not cause an increase in the number of complications, with high safety and promotion value.