中医辨证施护在肛瘘术后患者中的应用效果

Application Effect of Traditional Chinese Medicine Dialectical Nursing in Patients with Postoperative Anal Fistula

目的:探讨中医辨证施护在肛瘘术后患者中的应用效果。方法:选择九江市中医医院2019年11月—2020年11月收治的肛瘘患者为研究对象,按随机数表法将108例患者分为两组,每组各54例。对照组术后实施常规护理,观察组在常规护理基础上实施以中医理论为指导的辨证施护,两组患者均随访1个月。对比两组患者术后疼痛、恢复情况、自护能力、生活质量和并发症发生情况及护理满意度。结果:观察组干预后术后疼痛评分为(1.05±0.21)分,低于对照组的(2.65±0.24)分,差异有统计学意义(t=36.869,P<0.05)。观察组创面愈合、红肿消退、脓性分泌物消失、便血及住院时间分别为(20.22±3.19) d、(4.05±0.62) d、(3.97±0.45) d、(6.22±1.05) d和(13.63±2.93) d,均短于对照组的(25.26±4.12) d、(6.05±1.12) d、(6.25±1.33) d、(8.33±1.65) d和(16.31±3.32) d,差异有统计学意义(t=7.108、11.481、11.933、7.928、4.448,P<0.05)。干预后,观察组责任感、护理技能、健康知识认知及护理概念评分分别为(20.90±2.40)分、(40.45±5.77)分、(49.88±6.01)分、(27.34±2.95)分,均高于对照组的(17.39±2.74)分、(37.31±5.58)分、(42.30±5.96)分、(24.93±3.17)分,差异有统计学意义(t=7.081、2.875、6.581、4.090,P<0.05)。干预后,观察组生活质量评分为(80.85±6.05)分,高于对照组的(72.78±5.53)分,差异有统计学意义(t=7.235,P<0.05)。观察组并发症发生率(3.70%)低于对照组(14.81%),满意度(94.44%)高于对照组(81.48%),差异有统计学意义(χ^(2)=3.967,P<0.05;χ^(2)=4.285,P<0.05)。结论:对肛瘘术后患者实施以中医理论为指导的辨证施护,能够减轻其术后疼痛,提高其自护能力,减少术后并发症,促进患者康复,其术后生活质量和满意度均较高。

Objective: To explore the application effect of TCM dialectical nursing in patients with postoperative anal fistula.Methods: A total of 108 patients with anal fistula admitted to the hospital from November 2019 to November 2020 were selected and divided into two groups according to the random number table method, with 54 cases in each group. The control group was given routine nursing after operation, and the observation group was given dialectical nursing guided by TCM theory on this basis.Both groups were followed up for 1 month. The postoperative pain, recovery, self-care ability, quality of life, complications and nursing satisfaction were compared between the two groups. Results: The postoperative pain score of the observation group after intervention was(1.05±0.21) points, which was lower than(2.65±0.24) points of the control group, and the difference was statistically significant(t=36.869, P<0.05). The wound healing time, redness and swelling subsidence time, purulent secretion disappearance time, blood in the stool time and hospitalization time of observation group were(20.22±3.19) d,(4.05±0.62) d,(3.97±0.45) d,(6.22±1.05) d and(13.63±2.93) d, shorter than(25.26±4.12) d,(6.05±1.12) d,(6.25±1.33) d,(8.33±1.65) d and(16.31±3.32) d of the control group, the difference was statistically significant(t=7.108, 11.481, 11.933, 7.928, 4.448, P<0.05). After the intervention, the scores of responsibility, nursing skills, health knowledge cognition and nursing concept in the observation group were(20.90±2.40),(40.45±5.77),(49.88±6.01), and(27.34±2.95) points, higher than(17.39±2.74),(37.31±5.58),(42.30±5.96), and(24.93±3.17) points of the control group, and the differences were statistically significant(t=7.081, 2.875, 6.581, 4.090, P<0.05). After the intervention, the quality of life score of the observation group was(80.85±6.05) points, which was higher than(72.78±5.53) points of the control group, and the difference was statistically significant(t=7.235, P<0.05). The incidence of complications in the observation group(3.70%) was lower than that in the control group(14.81%), and the satisfaction rate(94.44%) was higher than that in the control group(81.48%), and the difference was statistically significant(χ^(2)=3.967, P<0.05, χ^(2)=4.285, P<0.05). Conclusion: Dialectical nursing for patients with anal fistula under the guidance of traditional Chinese medicine theory can reduce postoperative pain,improve their self-care ability, reduce postoperative complications and promote patients’ rehabilitation. Its postoperative quality of life and satisfaction are high.