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目的探讨肝胆管结石合并胆管癌患者在手术治疗后实施预见性护理干预的临床效果。方法选取2015年1月~2017年1月在我院接受手术治疗的88例肝胆管结石合并胆管癌疾病患者作为研究对象,随机分为对照组和观察组,每组各44例。对照组患者实施常规肝胆疾病手术护理,观察组患者实施预见性护理干预。对比两组患者在围术期内出现的不良反应例数、术后肛门排气时间、下床活动时间、住院时间、肝胆管结石合并胆管癌疾病手术治疗期间的护理服务满意度、护理干预前后VAS、SDS、SAS评分。结果观察组患者在围术期内仅出现2例(4.5%)不良反应,少于对照组的9例(20.5%),差异有统计学意义(P<0.05);观察组患者术后肛门排气时间、下床活动时间、住院时间短于对照组,差异有统计学意义(P<0.05);观察组患者对肝胆管结石合并胆管癌疾病手术治疗期间的护理服务满意度(95.5%)高于对照组(79.6%),差异有统计学意义(P<0.05);两组患者护理干预前后的VAS、SDS、SAS评分比较,差异有统计学意义(P<0.05);观察组患者干预后的各指标评分与对照组比较,差异有统计学意义(P<0.05)。结论肝胆管结石合并胆管癌患者在术后实施预见性护理干预,可以缩短术后恢复时间,减少相关不良反应发生率,控制疼痛,使患者保持平和心态,进而达到提高治疗效果和护理满意度的目的。
Objective To investigate the clinical effect of predictive nursing intervention in patients with hepatolithiasis complicated with cholangiocarcinoma after operation. Methods From January 2015 to January 2017, 88 patients with hepatolithiasis and cholangiocarcinoma undergoing surgical treatment in our hospital were randomly divided into control group and observation group, with 44 cases in each group. Patients in the control group underwent routine hepatobiliary surgery, and patients in the observation group received prospective nursing intervention. The number of adverse reactions in the two groups during perioperative period, postoperative anal exhaust time, ambulation time, hospital stay, care of patients with hepatolithiasis complicated with cholangiocarcinoma during the period of surgical treatment satisfaction, before and after nursing intervention VAS, SDS, SAS score. Results In the observation group, there were only 2 cases (4.5%) adverse reactions during the perioperative period, which was less than that in the control group (9 cases, 20.5%), with significant difference (P <0.05) Gas time, ambulation time and hospital stay were shorter than those in the control group (P <0.05). The satisfaction rate of nursing service (95.5%) in the treatment group during the operation of hepatolithiasis with cholangiocarcinoma (79.6%) in the control group (P <0.05). There was significant difference in the VAS, SDS and SAS scores between the two groups before and after nursing intervention (P <0.05). After the intervention in the observation group Score of each index compared with the control group, the difference was statistically significant (P <0.05). Conclusion The implementation of predictive nursing intervention in patients with hepatolithiasis and cholangiocarcinoma can shorten the postoperative recovery time, reduce the incidence of adverse reactions, control the pain and keep the patients calm, so as to improve the therapeutic effect and satisfaction of nursing purpose.