Orem自理模式在肝移植围手术期护理中的实效性探究  

Application effect of Orem self-care model in patients with liver transplantation

作　　者：刘军娜[1] 

机构地区：[1]天津市第一中心医院器官移植中心,天津300192

出　　处：《当代护士（上旬刊）》2018年第1期1-5,共5页Modern Nurse

基　　金：国家卫生和计划生育委员会重点专科建设项目;天津市卫生行业重点攻关项目资助(12KG102)

摘　　要：目的探讨应用Orem自理模式进行肝移植患者围手术期护理及其临床效果。方法将100例肝移植患者随机分为观察组(Orem自理模式组)50例,对照组(普通护理组)50例进行护理。结果观察组患者排气时间、下床活动时间、术后拔除尿管时间分别为(35.4±7.5)h、(23.2±4.6)h、(4.2±0.6)d,明显少于对照组的(52.1±11.7)h、(38.7±6.2)h、(6.1±1.2)d;观察组患者有效深呼吸掌握率、引流管自我护理掌握率、术后正确活动掌握率、合理饮食掌握率、术后免疫抑制剂服药掌握率及免疫抑制剂血药浓度稳定比例分别为100.00%、98.00%、98.00%、96.00%、100.00%、96.00%,明显高于对照组的90.00%、82.00%、76.00%、78.00%、90.00%、84.00%;观察组术后3 d出现腹胀的例数、术后并发肺不张及肺部感染的例数分别为3例、6例,明显低于对照组的13例、18例;以上差异均有统计学意义(P<0.05)。结论运用Orem自理模式中的三种护理系统,即完全补偿系统、部分补偿系统、辅助教育系统,对行肝移植手术的患者及家属进行针对性指导、支持,满足患者自理需要,达到自理满足,不仅增强肝移植患者自理能力,提高患者生命质量,同时减轻了家属负担,增加了社会效益。Objective To explore the perioperative nursing and clinical effect of Orem self-care model in patients with liver transplantation. Methods 100 patients with liver transplantation were randomly divided into observational group （Orem self-care model group） and control group （general nursing group）. There were 50 patients in each group. Results In the observation group, the exhausting time, the leaving bed time, time of postoperative removing urine tube were （35.4 ± 7.5） h, （23.2 ± 4.6） h, （4.2 ± 0.6） d respectively. These figures were significantly less than the control group of （52.1 ± 11.7） h, （38.7 ±6.2） h, （6.1 ± 1.2） d respectively. In the observation group, effective deep breathing mastery rate, the drainage tube self-care mastery rate, the correct postoperative activities mastery rate, reasonable diet mastery rate, postoperative immunosuppressive medication mastery rate and immunosuppressants stable blood drug concentration ratio were 100. 00%, 98.00%, 98.00%, 98.00%, 100.00%, 96.00% respectively. It was significantly earlier than the control group of 90.00%, 82.00%, 76.00%, 78.00%, 90.00% , 84.00% respectively. In the observation group, 3 patients developed abdominal distension and 6 patients with pulmonary atelectasis infection on three days after surgery. These figures were significantly lower than the control group of 13 cases and 18 cases. Both groups were statistically significant （P 〈 0.05 ）. Conclusion The three kinds of nursing systems in Orem self-care model （ Complete compensation system, partial compensation system, auxiliary education system） were used to help patients with liver transplantation and their families. It can meet the needs of self-care, enhance the self-care ability of patients with liver transplantation, improve the quality of life of patients, reduce the burden of family and increase social benefits.

关 键 词：OREM自理模式 肝移植 围手术期 

分 类 号：R473.6[医药卫生—护理学]