肝切除术后患者早期活动的最佳证据应用  

Implementation of best evidence on early mobilization among patients after liver resection

作　　者：宋剑平[1] 卢芳燕[2] 吴小燕[2] 徐彩娟[1] 封秀琴[1] 卢婕楠 杨静[2] 贺凤 金静芬[1] SONG Jianping;LU Fangyan;WU Xiaoyan;XU Caijuan;FENG Xiuqin;LU Jienan;YANG Jing;HE Feng;JIN Jingfen

机构地区：[1]浙江大学医学院附属第二医院护理部,杭州市310009 [2]浙江大学医学院附属第二医院肝胆胰外科,杭州市310009

出　　处：《中华护理杂志》2019年第8期1175-1179,共5页Chinese Journal of Nursing

基　　金：浙江省医药卫生科技计划项目(2019ZH021);浙江省教育厅项目(Y201838970,Y201839217)

摘　　要：目的基于肝切除术后患者早期活动的最佳证据总结,构建基于证据的质量审查指标,分析影响术后早期活动的主要障碍因素并实施相应的对策。方法开展全员培训与考核,建立每日活动目标并制订标准化作业流程,加强术前宣教,选择最佳活动时机,开展术后活动性疼痛评估,增添安全型活动辅助工具,调动患者离床活动的意愿和积极性,定期系统性地审核护理措施实施后的依从性和临床结果。结果医护人员对最佳证据的知晓率提高,患者术后首次下床活动时间提前,每日活动目标达成率提高,首次肛门排气时间提早,干预前后差异均有统计学意义(P<0.001);活动性疼痛评分≥4分的发生率降低,干预前后差异有统计学意义(P<0.05)。结论肝切除术后患者早期活动的最佳证据应用,能有效兼顾患者安全与快速康复。Objective Based on best evidence summary on early mobilization among patients after liver resection,evidence-based quality examination criteria were established,and barrier factors for early mobilization after liver resection were analyzed and corresponding countermeasures were implemented.Methods Carry out the training and examination for all medical staff,set up goals for daily activities and standard operating procedure,strength preoperative education,choose the best timing for early mobilization,assess postoperative pain during activities dynamically,use self-oriented assistant equipment,encourage patients to leave the beds,systematically and regularly review the compliance and clinical results.Results The countermeasures were able to improve knowledge in medical staff,make an earlier mobilization after surgery in patients,improve the completion rate of daily activities,make an earlier initial anal exhaust,decrease the incidence of severe pain(pain scored≥4).Conclusion Evidence-based practice ensure a safe and rapid recovery.

关 键 词：肝切除术 手术后期间 早日下床活动 循证实践 

分 类 号：R47[医药卫生—护理学]