子宫肌瘤切除术围术期路径式护理措施对患者应激反应及舒适度效果

Effect of the stress response and comfort of the perioperative path nursing for patients with myomectomy

目的:探究子宫肌瘤切除术围术期路径式护理措施对患者应激反应及舒适度效果。方法:收集2021年1月-2023年2月本院行子宫肌瘤切除术患者100例,随机数字表法分两组各50例,均采取常规护理,观察组增加路径化护理措施。比较两组术后相关指标、围术期应激反应(血压、心率和呼吸)、术后1d疼痛、护理干预前后的Kolcaba舒适状况量表(GCQ)、焦虑自评量表(SAS)和抑郁自评量表(SDS)及并发症。结果:与对照组比,观察组首次通气时间(0.89±0.19d)、首次下床时间(7.21±1.06h)和住院时间(3.12±1.03d)均低于对照组(1.01±0.25d、8.05±1.32h、4.06±1.12d);术中两组血压、心率和呼吸均不同程度增高,术后两组血压、心率和呼吸均不同程度降低且观察组术中和术后血压、心率和呼吸均低于对照组;术后观察组疼痛程度低于对照组,两组SAS、SDS均降低,GCQ均增高,且观察组变化幅度大于对照组;观察组总并发症率(8.0%)低于对照组(28.0%)(均P<0.05)。结论:子宫肌瘤切除术围术期采取路径化护理措施,可有效改善受术患者的应激反应及心理状态,增强患者术后舒适度,降低并发症发生,利于术后恢复。

Objective:To explore the effect of the stress response and comfort of the perioperative path nursing for patients with myomectomy.Methods:100 patients after myomectomy were selected and were divided into the control group and the observation group(50 cases in each group)according to the random number table method from January 2021 to February 2023.The patients in the two groups were given routine nursing,and the patients in the observation group were given perioperative path nursing additionally.The postoperative related indicators levels,the values of perioperative stress response(blood pressure,heart rate and respiration),the pain degree on the first day after operation,the scores by Kolcaba Comfort questionnaire(GCQ),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)before and after nursing intervention,and the complications rate of the patients were compared between the two groups.Results:The first ventilation time(0.89±0.19d),the time of the first time of getting out of bed(7.21±1.06h)and the hospital stay(3.12±1.03d)of the patients in the observation group were significantly lower than those(1.01±0.25d,8.05±1.32h and 4.06±1.12d)of the patients in the control group.The values of intraoperative blood pressure,heart rate and respiration of the patients in the two groups had increased to varying degrees,and the values of postoperative blood pressure,heart rate and respiration of the patients in the two groups had decreased to varying degrees,and all of which of the patients in the observation group were significantly lower than those of the patients in the control group(P<0.05).The degree of pain of the patients in the observation group was significantly lower than that of the patients in the control group.The scores of SAS and SDS of the patients in the two groups had decreased significantly,and the GCQ score of the patients in the two groups had increased significantly,and the changes of which in the observation group were significantly greater than those of the patients in the control group.The total complication rate(8.0%)of the patients in the observation group was significantly lower than that(28.0%)of the patients in the control group(all P<0.05).Conclusion:The perioperative path nursing for the patients with myomectomy can effectively improve their stress response and psychological state,enhance their postoperative comfort and reduce their incidence of complications,and which contributes to their postoperative recovery.