预见性护理在胆总管结石患者经内镜逆行胰胆管造影术取石术后的应用效果

Predictive nursing care for patients with common bile duct stones after endoscopic retrograde cholangiopancreatography stone removal

目的探讨预见性护理在胆总管结石患者经内镜逆行胰胆管造影术(ERCP)后的应用效果。方法选取2018年9月至2020年9月于烟台市烟台山医院行ERCP取石术治疗的胆总管结石患者108例,随机数字表法分为对照组和研究组,各54例。对照组男30例,女24例,年龄(62.4±1.6)岁;研究组男31例,女23例,年龄(61.7±1.4)岁。对照组应用常规护理,即常规术前告知注意事项、术后基础的生命体征检测等;研究组在此基础上应用预见性护理,包含心理护理、健康教育、并发症的预防3个方面。观察两组患者的汉密顿抑郁量表(HAMD)评分、汉密顿焦虑量表(HAMA)评分、生命质量(QOL)评分以及治疗相关指标情况。结果研究组患者的HAMD评分、HAMA评分均低于对照组[(21.1±3.9)分比(28.1±4.1)分、(21.3±4.2)分比(28.9±4.8)分],两组比较差异均有统计学意义(均P<0.001)。研究组患者的住院费用少于对照组[(20240.22±358.13)元比(33121.43±413.41)元],住院时间、排气时间、下床活动时间均短于对照组[(6.05±2.35)d比(10.08±6.17)d、(16.02±3.54)h比(25.16±3.08)h、(16.12±6.82)h比(24.15±7.16)h],两组比较差异均有统计学意义(均P<0.001)。研究组QOL评分中的症状评分、功能评分、健康状况评分均高于对照组[(84.3±8.1)分比(75.6±4.4)分、(79.3±8.1)分比(66.8±4.9)分、(70.9±8.2)分比(59.4±6.7)分],差异均有统计学意义(均P<0.001)。结论胆总管结石患者ERCP取石术后应用预见性护理效果理想,可以缩短患者的住院时间,减少经济压力,同时可以改善患者的负性情绪,提高治疗效果和生活质量,值得临床中推广和应用。

Objective To explore the effect of predictive nursing care for patients with choledocholithiasis after endoscopic retrograde cholangiopancreatography(ERCP)stone removal.Methods A total of 108 patients with choledocholithiasis treated by ERCP stone removal in Yantaishan Hospital from September 2018 to September 2020 were selected,and were divided into a control group and a study group by the randomnumber tablemethod,with 54 cases in each group.The control group had 30 males and 24 females,and were(62.4±1.6)years old.The study group had 31 males and 23 females,and were(61.7±1.4)years old.The control group took routine care,including routine pre-operative notices,basic vital sign detection after surgery,etc.;in addition,the study group took predictive care,including psychological care,health education,and prevention of complications.The scores of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),and quality of life(QOL)and treatment-related indicators of the two groups were observed.Results The scores ofHAMD andHAMAwere(21.1±3.9)and(21.3±4.2)in the study group,andwere(28.1±4.1)and(28.9±4.8)in the control group(both P<0.001).The hospitalization expense was(20240.22±358.13)yuan in the study group,and was(33121.43±413.41)yuan in the control group(P<0.001).The hospital stay,exhaust time,and time to get out of bed in the study group were shorter than those in the control group[(6.05±2.35)d vs.(10.08±6.17)d,(16.02±3.54)h vs.(25.16±3.08)h,and(16.12±6.82)h vs.(24.15±7.16)h;all P<0.001].The QOL scores of symptom,function,and health status in the study group were higher than those in the control group[(84.3±8.1)vs.(75.6±4.4),(79.3±8.1)vs.(66.8±4.9),and(70.9±8.2)vs.(59.4±6.7);all P<0.001].Conclusion The concept of rapid rehabilitation after ERCP stone removal for patients with choledocholithiasis has an ideal effect,and can reduce their hospital stay and economic pressure and improve their negative emotions,treatment effect,and quality of life,so it is worthy of clinical promotion and application.