PDCA模式联合临床路径护理对肝硬化腹水患者并发症发生率的影响

Effect of PDCA mode combined with Clinical pathway nursing on the incidence of complications in patients with cirrhotic ascites

目的探讨PDCA模式联合临床路径护理在肝硬化腹水患者中的应用效果,评估对患者腹水量、腹水程度、并发症发生率产生的影响。方法回顾性分析2020年1月至2022年1月华中科技大学同济医学院附属同济医院收治的90例肝硬化腹水患者的临床资料,按照护理模式将其划分为对照组(46例)和观察组(44例)。对照组应用PDCA护理加以干预,观察组联合应用PDCA模式和临床路径护理。对比2组的护理效果,评估项目包含并发症发生率、腹水程度、腹水量和肝功能指标。结果随访期间,观察组的并发症发生率低于对照组(P<0.05)。入院时,2组患者的腹水程度经统计学分析无显著差异(P>0.05);出院时,观察组腹水程度较轻于对照组(P<0.05)。入院时,2组患者腹水量对比无显著差异(P>0.05);观察组在入院后3 d、1周和出院时的腹水量均低于对照组(P<0.05)。入院时,观察组肝功能指标与对照组比较无显著性差异(P>0.05);出院时、出院后随访6个月,2组的肝功能指标参数均降低,且观察组低于对照组(P<0.05)。结论肝硬化腹水患者联合应用PDCA模式和临床路径护理能够有效减轻腹水量,在改善患者肝功能水平方面具有明显优势,还能够降低并发症发生的风险性。

Objective To explore the effect of combined application of PDCA mode and clinical pathway nursing for patients with cirrhotic ascites,and evaluate the impact on ascites volume,ascites degree,and complication rate.Methods A retrospective analysis was conducted on the clinical data of 90 patients with cirrhotic ascites admitted to Tongji Hospital Tongji Medical College of HUST from January 2020 to January 2022.They were divided into a control group(n=46)and an observation group(n=44)according to nursing mode.The control group applied PDCA nursing,and the observation group applied PDCA mode combined with clinical pathway nursing.The nursing effect of the two groups was compared,and the evaluation items included complication rate,ascites degree,ascites volume and liver function index.Results During the follow-up period,the complication rate in the observation group was lower than that in the control group(P<0.05).At admission,there was no significant difference in the degree of ascites between the two groups(P>0.05);At discharge,the ascites degree in the observation group was better than that in the control group(P<0.05).At admission,there was no significant difference in ascites volume between the two groups(P>0.05);At 3 days and 1 week after admission and at discharge,the ascites volume in the observation group was lower than that in the control group(P<0.05).At admission,there was no significant difference in liver function indicators between the control group and the observation group(P>0.05);At discharge and 6 months of follow-up after hospitalization,liver function indexes in both groups decreased,and the liver function indexes of the observation group were lower than those of the control group(P<0.05).Conclusion The combination of PDCA mode and clinical pathway nursing for patients with cirrhotic ascites has outstanding effects on reducing ascites volume and improving the liver function of patients,and can effectively prevent potential complications.