延续性个案管理在行经皮肝穿刺胆道引流术患者中的应用效果  

Application effect of continuous case management in patients undergoing percutaneous transhepatic cholangial drainage

作　　者：李娜[1] 李作坤 汤淼[1] LI Na;LI Zuokun;TANG Miao(The Second Hospital of Dalian Medical University,Dalian,116027,China)

机构地区：[1]大连医科大学附属第二医院重症医学科,辽宁省大连市116027

出　　处：《护理实践与研究》2022年第19期2921-2925,共5页Nursing Practice and Research

基　　金：2020年大连市中医药医学科学研究计划项目(编号:20Z12006)。

摘　　要：目的探讨延续性个案管理在行经皮肝穿刺胆道引流(PTCD)治疗老年患者中的应用效果。方法将2020年11月—2021年12月大连市某三级甲等医院77例行PTCD引流术后携带引流管出院的老年患者作为研究对象,按基本资料组间匹配原则将患者分为观察组39例和对照组38例。对照组给予常规出院护理,观察组在对照组基础上接受为期6个月的延续性个案管理干预,比较两组患者并发症的发生率、自我管理能力和生活质量。结果干预6个月后,观察组老年患者胆道感染、引流管堵塞、引流管脱出、伤口感染等并发症发生率低于对照组,差异具有统计学意义(P<0.05);观察组老年患者慢性病自我管理量表总得分低于对照组,差异有统计学意义(P<0.05);观察组老年患者生活质量水平得分高于对照组,差异有统计学意义(P<0.05)。结论对PTCD引流术后携带引流管出院的老年患者实施延续性个案管理可以降低患者并发症的发病率,提高患者的自我管理能力及生活质量。Objective To explore the application effect of continuing case management in elderly patients undergoing percutaneous transhepatic cholangial drainage(PTCD).Methods From November 2020 to December 2021,77 elderly patients discharged with drainage tube after PTCD drainage in a Class III Grade A hospital in Dalian were selected as the research objects.According to the principle of inter-group matching of basic data,the patients were divided into an observation group(n=39)and a control group(n=38).The control group received routine discharge nursing,the observation group received continuous case management intervention for 6 months on the basis of the control group.The incidence of complications,self-management ability and quality of life were compared between the two groups.Results After 6 months of intervention,the incidence of biliary tract infection,drainage tube blockage,drainge tube withdraw,wound infection and pipe-related complications in the observation group was lower than the control group,the diff erences were statistically signifi cant(P<0.05).The total score of chronic disease self-management scale in the observation group was lower than the control group,the diff erence was statistically significant(P<0.05).The score of quality of life of elderly patients in observation group was higher than the control group,the diff erence was statistically signifi cant(P<0.05).Conclusion Continuous case management for elderly patients discharged with drainage tube after PTCD drainage could reduce the incidence of complications and improve the self-management ability and quality of life of patients.

关 键 词：个案管理 延续性护理 经皮肝穿刺胆道引流 老年患者 自我管理能力 生活质量 

分 类 号：R473.6[医药卫生—护理学]