临床护理路径在巨脾型晚期血吸虫病快速康复外科流程中的应用  

Application of clinical nursing pathway in fast-track program of splenomegaly advanced schistosomiasis patients

作　　者：周瑞红[1] 刘佳新[1] 潘洁[1] 周璐[1] 刘玲[1] 李琴[1] 

机构地区：[1]湖南省血吸虫病防治所附属湘岳医院,国家血吸虫病临床重点专科,岳阳414000

出　　处：《中国血吸虫病防治杂志》2015年第5期506-509,共4页Chinese Journal of Schistosomiasis Control

基　　金：湖南省科技厅科研项目(2012SK3269);国家临床重点专科建设项目(卫办医政函[2012]649)

摘　　要：目的评价快速康复外科(FTS)流程的临床护理路径(FTS-CNP)在围手术期巨脾型晚期血吸虫病(晚血)患者中的应用效果。方法将2012年1月-2014年12月在本院择期手术治疗的80例巨脾型晚血患者随机分为观察组和对照组,每组40例。观察组实施FTS-CNP,对照组实施常规护理。观察两组患者术后生理康复情况及心理健康水平。结果观察组患者术后首次进食时间[(14.67±2.90)h]、肛门排气时间[(25.30±3.46)h]、下床活动时间[(29.40±5.57)h]、住院时间[(19.00±2.82)d]均短于对照组[分别为(44.50±6.71)h、(52.80±6.95)h、(35.05±10.37)h、(25.08±2.39)d],且术后并发症发生率(7.50%)低于对照组(25.00%),差异均有统计学意义(P均<0.05)。术后观察组患者焦虑自评量表评分[(41.22±5.60)分]、抑郁自评量表评分[(40.28±6.67)分]均低于对照组[(46.89±8.92)分、(47.06±10.29)分],差异均有统计学意义(P均<0.01)。结论 FTS-CNP可促进围手术期巨脾型晚血患者术后快速康复,减少住院时间及术后并发症,促进患者心理健康。Objective To evaluate the effect of clinical nursing pathway in fast-track program（FTS-CNP）in splenomegaly advanced schistosomiasis patients during the perioperative period. Methods A total of 80 patients with splenomegaly advanced schistosomiasis who were treated with selective operation in the Affiliated Xiangyue Hospital of Hunan Institute of Parasitic Diseases from January,2012 to December,2014 were divided into an observation group（n = 40）and a control group（n = 40）.FTS-CNP was implemented in the observation group,while the routine nursing was used in the control group. Then the physical rehabilitation and psychological health levels of the patients in the two groups post-operation were observed and compared. Re Results After the operation,the duration of first taking food[（14.67 ± 2.90）h],first anus exhausting[（25.30 ± 3.46）h],first off-bed activity[（29.40 ± 5.57）h],as well as the duration of hospital stays[（19.00 ± 2.82）d]of patients in the observation group were all shorter than those of the patients in the control group[（44.50 ± 6.71）h,（52.80 ± 6.95）h,（35.05 ± 10.37）h,（25.08 ± 2.39）d,respectively],and the incidence rate of postoperative complications（7.50%）of the former was lower than that of the latter（25.00%）,and all the differences were statistically significant（all P〈0.05）. Both the scores of SAS（41.22 ±5.60）and SDS（40.28 ± 6.67）of the patients in the observation group were lower than those of the patients in the control group（46.89± 8.92,47.06 ± 10.29）,both differences were statistically significant（both P〈0.01）. Conclusion FTS-CNP can promote the physical and psychological recovery of the splenomegaly advanced schistosomiasis patients post-operation,and also can shorten the hospitals stays and reduce the complications.

关 键 词：晚期血吸虫病 巨脾型 快速康复外科 临床护理路径 围手术期护理 

分 类 号：R532.21[医药卫生—内科学]