共享决策模型干预在急诊腹腔镜胃癌根治术患者中的应用效果

Application effect of shared decision model intervention in emergency laparoscopic gastrectomy patients

目的目的探讨共享决策模型干预在急诊腹腔镜胃癌根治术(LG)患者中的应用效果。方法方法将92例急诊行LG治疗的胃癌患者按干预方式的不同分为对照组40例和观察组52例,对照组采取急诊常规干预,观察组采取共享决策模型干预。比较两组患者的生理指标[脉率(PR)、舒张压(DBP)、收缩压(SBP)]、急救时间、参与决策满意度评分以及并发症发生情况。结果结果干预后,两组患者PR、DBP、SBP均较干预前降低,且观察组患者PR、DBP、SBP均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者分诊评估时间、心电图检查时间、采血时间、建立静脉通道时间及入院至手术时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。观察组患者决策、协商交流、总满意度和信心及信息评分均高于对照组,差异均有统计学意义(P﹤0.05)。两组患者术后并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论结论共享决策模型干预对改善急诊LG患者的生理指标有一定意义,能缩短急救时间,同时还能提高患者满意度。

Objective To investigate the effect of shared decision model intervention in emergency laparoscopic gas-trectomy(LG)patients.Method A total of 92 patients with gastric cancer treated by LG in emergency were divided into control group(40 cases)and observation group(52 cases)according to different intervention methods.The control group received emergency routine intervention,and the observation group received shared decision model intervention.Physio-logical indicators[pulse rate(PR),diastolic blood pressure(DBP),systolic blood pressure(SBP)],satisfaction score of participation in decision making and the incidence of complications were compared between the two groups.Result Af-ter intervention,the PR,DBP and SBP in two groups were lower than those before intervention,and the PR,DBP and SBP in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The triage evaluation time,electrocardiogram examination time,blood collection time,venous channel establishment time and time from admission to operation time in observation group were significantly shorter than those in control group,the differences were statistically significant(P<0.01).The scores of decision-making,negotiation and communica-tion,total satisfaction and confidence,information in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postopera-tive complications between the two groups(P>0.05).Conclusion The shared decision model intervention has a certain significance to improve the physiological indicators of LG patients in emergency,shorten the emergency time,and im-prove patient satisfaction.