基于4R危机理论的干预在降低内镜下结肠息肉术后患者低血糖发生率中的应用研究

Effect of 4R crisis theory‐based nursing intervention on hypoglycemia in patients after endoscopic colon polypectomy

目的探讨基于4R危机理论的干预在降低内镜下结肠息肉术后患者低血糖发生率中的效果。方法选取2021年1月至2022年8月在海军军医大学第一附属医院接受内镜下结肠息肉治疗的患者500例,按随机数字表法分作2组,对照组250例予以常规护理,观察组250例在常规护理基础上行基于4R危机理论的干预。对比2组围手术期血糖水平与低血糖发生情况、手术并发症发生情况、术后康复质量及护理满意度。结果观察组术后即刻、术后1 h、术后24 h的血糖水平高于对照组(P<0.05);观察组低血糖发生率为0.80%,低于对照组的3.60%(P<0.05);观察组的手术并发症发生率为1.60%,低于对照组的5.20%(P<0.05);观察组术后7 d时的40项术后恢复质量调查问卷(QoR-40)评分高于对照组(P<0.05);观察组的护理满意度为98.80%,高于对照组的95.20%(P<0.05)。结论基于4R危机理论的干预应用于内镜下结肠息肉手术患者,可有效降低术后低血糖发生率,减少手术并发症的发生,进一步提升患者术后恢复质量,提高其护理满意度。

Objective To explore the effect of nursing intervention based on 4R crisis theory on hypoglycemia in patients after endoscopic colon polypectomy.Methods Five hundred patients undergoing endoscopic colon polypectomy in The First Affiliated Hospital of Naval Medical University from January 2021 to August 2022 were selected and randomly divided into two groups,with 250 cases in each group.The control group was given routine nursing,and the observation group was given 4R crisis theory⁃based intervention on the basis of routine nursing.Perioperative blood glucose and hypoglycemia,surgical complications,postoperative rehabilitation and patient’s satisfaction were compared between the two groups.Results The blood glucose level in the observation group was higher than that in the control group immediately,1 h and 24 h after operation(P<0.05).The incidence of hypoglycemia in the observation group was lower than that in the control group(0.80%vs.3.60%,P<0.05).The incidence of surgical complications in the observation group was lower than that in the control group(1.60%vs.5.20%,P<0.05).The score of quality of recovery⁃40(QoR⁃40)questionnaire in the observation group was higher than that in the control group on day 7 after operation(P<0.05).The degree of satisfaction for nursing in the observation group was higher than that in the control group(98.80%vs.95.20%,P<0.05).Conclusion Intervention based on 4R crisis theory can effectively reduce the incidence of postoperative hypoglycemia and surgical complications,further improve the quality of postoperative recovery and the degree of satisfaction for nursing in patients undergoing endoscopic colon polypectomy.