多学科协作护理模式在内镜下套扎术治疗食管静脉曲张出血中的应用

Study on the effect of multidisciplinary collaborative care model combined with endoscopic ligation on esophageal variceal bleeding

目的分析多学科协作护理模式在内镜下套扎术治疗食管静脉曲张出血中的应用效果。方法选取2018年1月—2020年12月洛阳市某医院收治的食管静脉曲张出血患者108例为研究对象,根据入院顺序分为对照组(54例)、研究组(54例)。2组患者均予以内镜下套扎术治疗,对照组患者给予常规护理干预,观察组患者给予多学科协作护理模式干预。比较2组患者干预前、出院时的负性情绪[抑郁自评量表(SDS)、焦虑自评量表(SAS)]、自我管理行为及自我效能感评分,比较2组患者并发症发生情况。结果与干预前比较,出院时2组患者社会心理行为、饮食行为、治疗行为、躯体活动、自我效能感评分均升高,且研究组高于对照组,差异均有统计学意义(P<0.05);2组患者SDS、SAS评分均降低,且研究组低于对照组(P<0.05)。研究组患者迟发性再出血、吞咽困难的发生率分别为5.56%、5.56%,低于对照组的20.37%、22.22%,差异均有统计学意义(P<0.05)。结论多学科协作护理模式结合内镜下套扎术可改善食管静脉曲张出血患者自我管理行为及负性情绪,提高其自我效能感,降低其术后并发症发生率,安全性高,值得临床进一步研究与应用。

Objective To analyze the therapeutic effect of multidisciplinary collaborative care model combined with endoscopic ligation on esophageal variceal bleeding.Methods One hundred and eight patients with esophageal variceal bleeding admitted to a hospital in Luoyang from January 2018 to December 2020 were selected as study subjects and divided into control group(54 cases)and study group(54 cases)according to the order of admission.Patients in both groups were treated with endoscopic ligation.The patients in the control group were given conventional nursing interventions while the patients in the observation group were given multidisciplinary collaborative nursing model interventions,and both groups received nursing care until discharge.The negative emotions,self-management behaviors and self-efficacy scores of patients in the two groups before and after the intervention were compared,and the occurrence of complications in the two groups was compared.Results At discharge,the social psychosocial behavior,eating behavior,therapeutic behavior,somatic activity,and self-efficacy scores were higher in both groups than before intervention,and those in the study group were higher than the control group(P<0.05);SDS and SAS scores were lower in both groups,and lower in the study group than in the control group(P<0.05).The incidence of delayed rebleeding and dysphagia in the study group was 5.56%and 5.56%,respectively,which was lower than that in the control group(20.37%and 22.22%,P<0.05).Conclusion The multidisciplinary collaborative care model combined with endoscopic ligation can improve the self-management behaviors and negative emotions of patients with esophageal variceal bleeding,increase their self-efficacy,and reduce their postoperative complication rates with high safety.Therefore,it is worthy of further clinical study and application.