全程护理优化方案对内镜下行内痔套扎术围手术期患者疼痛指数、生活质量及并发症的影响

Effect of perioperative application of whole process nursing optimization plan on pain index,quality of life,and complications of patients undergoing endoscopic ligation of internal hemorrhoids

目的分析镜下行内痔套扎术围手术期应用全程护理优化方案对患者疼痛指数、生活质量及并发症的影响。方法收集2022年1月至2023年1月收治的70例内镜下行内痔套扎术治疗的内痔患者临床资料,根据围手术期干预方式差异分为对照组(常规干预)与观察组(全程护理优化方案干预),每组35例。记录并对比2组手术时间、术中出血量、创面愈合时间、疼痛情况[视觉模拟疼痛评分(VAS)]、生活质量[生活质量综合评定问卷-74(GQOLI-74)]及并发症发生情况[肛门坠胀感、水肿、术后出血、尿潴留]。结果观察组手术时间及创面愈合时间均短于对照组,术中出血量少于对照组(P<0.05);2组术后24 h VAS评分比较差异无统计学意义(P>0.05),观察组术后3 d、7 d VAS评分均低于对照组(P<0.05);2组干预前生活质量四个维度比较差异无统计学意义(P>0.05),干预后2组患者四个维度评分均提高,观察组干预后物质生活、躯体、心理以及社会功能评分均高于对照组(P<0.05);术后观察组并发症总发生率为2.22%,对照组为4.44%,差异无统计学意义(P>0.05)。结论内镜下行内痔套扎术围手术期应用全程护理优化方案可降低患者疼痛指数及并发症发生率,同时提高患者生活质量水平,值得临床推广。

Objective To analyze the effect of perioperative application of whole process nursing optimization plan on pain index,quality of life,and complications of patients undergoing endoscopic ligation of internal hemorrhoids.Methods Clinical data of 70 patients undergoing endoscopic ligation of internal hemorrhoids admitted to our hospital from January 2022 to January 2023 were collected.According to the differences in perioperative intervention,they were divided into a control group(routine intervention,n=35)and an observation group(perioperative application of whole process nursing optimization plan,n=35).The operation time,intraoperative bleeding,wound healing time,visual analog pain score(VAS)for pain,the scores of Quality of Life Comprehensive Assessment Questionnaire(GQOLI-74),and the complications(anal distension,edema,postoperative bleeding,urinary retention)of the two groups were recorded and compared.Results The operation time and wound healing time in the observation group were significantly shorter than those of the control group,and the intraoperative bleeding was significantly less(P<0.05).There was no statistically significant difference in 24-hour VAS scores between the two groups after surgery(P>0.05),but 3-day and 7-day VAS scores in the observation group were significantly lower than those of the control group(P<0.05).There was no difference in the four dimensions scores of GQOLI-74(material life,physical,psychological,and social function)between the two groups before intervention(P>0.05),but the scores were significantly improved in the two groups compared with before intervention,and which in the observation group were more pronounced relative to the control group(P<0.05).The total incidence of postoperative complications in the observation group was comparable to the control group(2.22%vs 4.44%,P>0.05).Conclusion For patients undergoing endoscopic ligation of internal hemorrhoids,the perioperative application of whole process nursing optimization plan can reduce patients’pain index incidence of complications,and improve their quality of life,which is worthy of clinical promotion.