基于协同理论指导的双环节护理在胆胰疾病ERCP术后患者中的效果观察

Effect of dual-link nursing based on collaborative theory guidance on patients with biliary and pancreatic diseases after ERCP

目的探讨基于协同理论指导的双环节护理对胆胰疾病内镜逆行胰胆管造影术(ERCP)后患者恢复情况、自护能力和心理状态的影响。方法选取2019年3月—2021年7月于医院进行治疗的111例胆胰疾病行ERCP患者作为研究对象,按照组间基本特征具有可比性的原则分为对照组55例和观察组56例,对照组予以常规护理,观察组予以基于协同理论指导的双环节护理。采用简式心境状态量表(POMS)、消化道相关生存质量指数量表(GIQLI)以及自我护理能力测定量表(ESCA)评价患者护理干预前后的心理状态、生活质量以及自我护理能力。比较两组患者术后引流情况,住院天数、首次排气时间、鼻胆管拔管时间、并发症发生率以及POMS、GIQLI、ESCA评分。结果观察组患者住院天数、首次排气时间以及鼻胆管拔管时间分别为6.13±1.12 d、1.28±0.31 d、3.16±0.54 d,均短于对照组的7.04±1.29 d、1.64±0.52 d、3.82±0.63 d,差异有统计学意义(P<0.05);观察组患者ERCP术后出现急性胆管炎1例,发热腹痛1例,总发生率为3.57%,对照组患者ERCP术后出现急性胰腺炎2例,急性胆管炎1例,发热腹痛4例,高淀粉酶血症2例,总发生率为16.36%,观察组患者ERCP术后并发症总发生率低于对照组(P<0.05)。护理干预后,观察组患者POMS消极情绪评分低于对照组,积极情绪评分和GIQLI、ESCA各维度评分均高于对照组(P<0.05)。结论双环节协同护理应用于胆胰疾病ERCP术后患者,可促进其术后早日康复,降低术后并发症发生率,且能改善患者心理状态和生活质量。

Objective To explore the effect of dual-link nursing based on collaborative theory guidance on the recovery status,self-care ability and psychological state of biliary and pancreatic diseases after endoscopic retrograde cholangiopancreatography(ERCP)patients.Methods 111 patients with biliary and pancreatic diseases undergoing ERCP who received treatment in the hospital from March 2019 to July 2021 were selected as the study subjects.According to the principle of comparability of basic characteristics,the patients were divided into control group(55 cases)and observation group(56 cases).The control group was given traditional nursing,the observation group was given dual-link collaboration nursing.Profile of Mood States(POMS),Gastrointestinal Quality of Life Index(GIQLI)and Exercise of Self-Care Agency Scale(ESCA)were used to evaluate the psychological state,quality of life and self-care ability of patients before and after intervention.The postoperative drainage status,hospital stay days,first exhaust time,nasobiliary extubation time,incidence rates of complications,POMS,GIQLI and ESCA were compared between the two groups of patients.Results The hospital stay,first exhaust time and nasobiliary extubation time with 6.13±1.12 d,1.28±0.31 d and 3.16±0.54 d in observation group were shorter than with 7.04±1.29 d,1.64±0.52 d,3.82±0.63 d in control group the difference was statistically signifcant(P<0.05).1 case of acute cholangitis and 1 case of fever and abdominal pain occurred in observation group after ERCP,with total incidence rate of 3.57%.There were 2 cases of acute pancreatitis,1 case of acute cholangitis and 4 cases of fever and abdominal pain in control group after ERCP,with total incidence rate of 16.36%.The total incidence rate of complications after ERCP in observation group was lower than the control group(P<0.05).After nursing intervention,the negative emotion score of POMS of patients was lower while the positive emotion score and scores of dimensions of GIQLI and ESCA were higher in observation group compared to control group(P<0.05).Conclusion Dual-link collaboration nursing for biliary and pancreatic diseases after ERCP can promote the postoperative early rehabilitation of patients,reduce the incidence rates of postoperative complications,improve the psychological state and quality of life.