多学科合作的一体化护理干预在经口胰胆管镜围诊疗期中的应用  

Application of nursing intervention based on multidisciplinary collaboration and integration in patients undergoing per-oral cholangiopancreatoscopy during the period of diagnosis and treatment

作　　者：欧阳剑波[1] 肖广发[1] 阳建怡[1] 吴智勇 杨园利[1] 周军[1] 高红梅[2] 彭淑平[3] OUYANG Jianbo1, XIAO Guangfa1, YANG Jianyi1, WU Zhiyong1, YANG Yuanli1, ZHOU Jun1,GAO Hongmei2, PENG Shuping3(1. Department of General Surgery ;2. Department of Nursing, Xiangya Hospital, Central South University, Changsha 410008, China; 3. Cancer Research Institute, Central South University, Changsha 410078, China)

机构地区：[1]中南大学湘雅医院普通外科,湖南长沙410008 [2]中南大学湘雅医院护理部,湖南长沙410008 [3]中南大学肿瘤研究所,湖南长沙410078

出　　处：《中国普通外科杂志》2018年第9期1160-1166,共7页China Journal of General Surgery

基　　金：湖南省卫计委科研计划资助项目(B2016111)

摘　　要：目的:探讨多学科合作的一体化护理干预在经口胰胆管镜(PCPS)围诊疗期应用的可行性和有效性。方法:将96例胰胆管疾病需行PCPS诊疗的患者按入院顺序随机分为观察组(49例)和对照组(47例)。对照组患者围诊疗期接受常规护理干预,观察组患者围诊疗期接受多学科合作的一体化护理干预,主要干预措施包括知情同意、诊疗前讨论、风险评估、患者准备、PCPS具体准备、医护配合、护患配合及术中与术后监管等。采用焦虑状态-特质问卷(STAI)、Frankl量表以及自行设计的调查表,评价两组患者焦虑程度、诊疗配合程度及舒适度与满意度情况,同时记录患者的收缩压和心率变化以及并发症情况。结果:观察组在焦虑程度、收缩压和心率变化、诊疗配合程度和舒适度均明显优于对照组(均P<0.05)。同时,与对照组比较,观察组干预后满意率明显增加,治疗相关并发症发生率明显降低(均P<0.05)。结论:在PCPS患者围诊疗期中,通过采用多学科合作的一体化护理干预,可以减轻患者焦虑、抑郁等应激不适,改善患者的血压、心率变化,提高患者配合程度、舒适度及满意度,降低并发症发生率。Objective： To investigate the feasibility and effectiveness of nursing intervention based on multidisciplinary collaboration and integration in patients undergoing per-oral cholangiopancreatoscopy （PCPS） during the period of diagnosis and treatment. Methods： Ninety-six patients with pancreatobiliary duct diseases requiring PCPS treatment were randomly allocated by the order of admission to observation group （49 cases） and control group （47 cases）. During the period of diagnosis and treatment, the patients in control group received conventional nursing intervention, while those in observation group received nursing intervention based on multidisciplinary collaboration and integration, which mainly included the informed consent, discussion before diagnosis and treatment, risk assessment, psychological preparation of patient, PCPS specific preparation, cooperation between medical and nursing care, nurse-patient cooperation and the intra- and postoperative supervision. Using the State-Trait Anxiety Inventory （STAI）, Frankl Scale and self-designed questionnaires, the degree of anxiety, medical compliance, comfort level and satisfaction rate of the patients of the two groups were assessed, and the systolic blood pressure, heart rate and complications of the patients were also recorded. Results： Observation group was significantly superior to control group in terms of degree of anxiety, changes in systolic blood pressure and heart rate, patients＇ medical compliance and comfort levels （all P〈0.05）. Meanwhile, the satisfaction rate was significantly increased after intervention and the incidence of treatment-associated complications was significantly reduced （all P〈0.05）. Conclusion： Through nursing intervention based on multidisciplinary collaboration and integration during the period of diagnosis and treatment, the stress discomforts such as anxiety and depression can be alleviated, the changes in blood pressure and heart rate can be reduced, the medical compliance, comfort level an

关 键 词：胰腺疾病 胆管疾病 内窥镜检查 消化系统 心理疗法 

分 类 号：R657.5[医药卫生—外科学]