多元化护理方案在功能性鼻内镜手术患者中的应用

The application of diverse care schemes among patients with functional endoscopic sinus surgery

目的探讨多元化护理方案在功能性鼻内镜手术患者中的应用及临床效果。方法选取2018年1月~2019年5月在我院耳鼻咽喉头颈外科接受鼻内镜手术治疗的患者60名,根据随机数字表分为观察组与对照组各30例。对照组采取常规护理、健康教育、心理护理;观察组患者将采用多层面、多因素、多环节、多干预模式多元化护理方案模式。比较两组术后焦虑状态、手术对手术疼痛耐受率、自我效能提高、术后发生不适症状等指标。结果观察组干预后的焦虑自评量表(SAS)得分值低于对照组,而干预后自我效能感水平(GSES)积分高于对照组,两组间差异有统计学意义(P<0.05)。观察组中I级和Ⅱ级鼻部胀痛共占90%,无Ⅳ级鼻部胀痛发生,对照组中I级和Ⅱ级鼻部胀痛共占60%,有4例患者达到鼻部胀痛Ⅳ级,两组鼻部胀痛级别分布差异具有统计学意义(P<0.05)。观察组术后发生4例不适症状(13.33%),对照组术后发生11例不适症状(36.67%),两组比较差异有统计学意义(P<0.05)。结论对鼻内镜手术患者进行多元化方案模式护理可以有效降低患者由于手术产生的焦虑等负性情绪,提高患者自我效能感,减少患者术后不适感,提高患者术后满意度。

Objective To explore the application and clinical effect of diverse care schemes among patients with functional endoscopic sinus surgery.Methods A total of 60 patients who received endoscopic nasal surgery in the department of otolaryngology head and neck surgery of our hospital from January 2018 to May 2019.were divided into experimental group(n=30)and control group(n=30)according to the random number table.The control group was given routine nursing,health education and psychological care;while the experimental group was given diverse care schemes with a multi-layer,multi-factor,multi-link,multi-intervention mode.Results The scores of SAS and SDS in the experimental group were lower than those in the control group(P all<0.05).The score of GSES in the experimental group was higher than that in the control group(P<0.05).The difference of pain levels at 24h after surgery was statistically significant,the number of people with lower pain level was higher in experimental group(P<0.05).It was statistically different that patients’anxiety in the two groups(P<0.05).The incidences of disabling symptoms were 13.33%in the experimental group and 36.67%in the control group(P<0.05).Conclusions The implementation of the intervention measures of preoperative nasal stuffing combined with care schemes can effectively,relieve postoperative pain and anxiety,reduce complications,and thus improve postoperative satisfaction of patients.