职业性手臂振动病患者基于循证的护理干预  

Evidence-based Nursing Intervention in Occupational Hand-arm Vibration Disease

作　　者：邱新香[1] 夏丽华[1] 郑倩玲[1] 梁伟辉[1] 郭卫军[1] 陈慈珊[1] 

机构地区：[1]广东省职业病防治院,广东广州510300

出　　处：《护理学报》2014年第11期59-62,共4页Journal of Nursing（China）

基　　金：国家临床重点专科建设项目经费资助(2011-09);广东省职业病防治重点实验室(2012A061400007);广东省医学科学研究基金(A2012066)

摘　　要：目的探讨职业性手臂振动病(hand-arm vibration disease,HAVD)科学有效的护理方法。方法成立循证护理小组,针对2011年1月—2012年6月收治的126例手臂振动病住院患者的护理问题,通过计算机检索维普期刊全文数据库,中国期刊全文数据库、万方医学数据库、MEDLINE、SCI等数据库寻找文献支持,并结合临床实践,为本组患者制定、实施科学系统的循证护理方案。结果入院时本组患者手麻、手痛和双手痛觉、触觉与振动觉减弱发生率分别是100%、68.3%、92.1%、94.4%、42.9%,冷水复温试验、神经肌电图检查异常率92.9%、100%。实施循证护理实践方案后手麻、手痛和双手痛觉、触觉与振动觉减弱得到改善的总有效率分别为96.1%、97.6%、58.6%、56.3%、59.3%,冷水复温试验、神经肌电图检查异常治疗后总有效率分别为88.0%、97.6%。结论采用循证方法为手臂振动病患者实施整体护理,提高了患者对疾病相关知识知晓度和治疗依从性,住院期间患者未发生负性心理应对事件,积极配合治疗,改善了受损末梢神经和微循环。Objective To explore a scientific and effective nursing method for occupational hand-arm vibration disease （HAVD）. Methods An evidence-based nursing team was established. From January 2011 to Jane 2012, 126 cases of hospitalized patients with HAVD were included as subject. Literature review was conducted by computer retrieval in VIP, CNKI, MEDLINE and SCI and specific evidence-based nursing intervention was then developed combined with clinical practice. Results The occurrence of numbness, pain, weakening of algesthesia, thigmesthesia and pallesthesia of both hands decreased from 100%, 68.3%, 92.1%, 94.4%, 42.9%respectively before the treatment to 96.1%, 97.6%, 58.6%, 56.3%, 59.3% respectively after the treatment and the abnormal rate of cold water temperature test （CWLT） and neuromuscular electrical diagram （ENMG） decreased from 92.9% and 100% before treatment to 88.0% and 97.6% after treatment. Conclusion Evidence-based nursing intervention benefits the improvement of knowledge and compliance of patients with HAVD and lays a foundation for the development of standardized nursing and clinical nursing path.

关 键 词：职业性手臂振动病 循证实践 护理 

分 类 号：R139.2[医药卫生—劳动卫生]