协同护理结合医护一体化模式在小儿泌尿系统结石微创手术中应用的效果评价  

Application of collaborative nursing combined with medical integration model in minimally invasive surgery for urinary calculi in children

作　　者：王莎 郑智慧[1] 高婷婷 Wang Sha;Zheng Zhihui;Gao Tingting(Department of Urology,Children′s Hospital Affiliated to Zhejiang University Medical College,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属儿童医院泌尿外科,杭州310000

出　　处：《中国实用护理杂志》2023年第35期2746-2750,共5页Chinese Journal of Practical Nursing

摘　　要：目的探讨协同护理结合医护一体化模式在小儿泌尿系统结石微创手术中的应用效果,为小儿泌尿系统结石微创手术护理提供临床指导。方法采用类实验研究方法,选取2020年12月至2022年7月浙江大学医学院附属儿童医院就诊的90例行泌尿系统结石微创手术的患儿作为研究对象。依据入组时间顺序分为观察组(n=45)和对照组(n=45),对照组予以常规护理模式护理,观察组予以协同护理结合医护一体化模式护理。比较2组临床相关指标、疼痛情况、焦虑状态、依从性及并发症发生情况。结果观察组手术操作时间、术中出血量、术后首次下床时间、术后即刻清石率及术后1个月清石率分别为(75.48±5.92)min、(168.75±17.28)ml、(6.12±1.05)h、84.44%(38/45)、97.78%(44/45),对照组分别为(78.39±6.75)min、(178.30±19.25)ml、(6.84±1.23)h、64.44%(29/45)、82.22%(37/45),2组比较差异均有统计学意义(t/χ^(2)=2.17、2.48、2.99、4.73、6.05,均P<0.05)。观察组术后1、3、7 d的患儿行为学疼痛量表评分分别为(6.28±1.21)、(5.35±1.37)、(2.87±0.65)分,对照组分别为(7.05±1.55)、(5.95±1.25)、(3.21±0.73)分,2组比较差异均有统计学意义(t=2.63、2.17、2.33,均P<0.05)。观察组出院前1 d的耶鲁围手术期焦虑量表评分和Frankl依从性量表评分分别为(55.28±5.52)、(3.60±0.40)分,对照组为(60.02±8.56)、(2.82±0.61)分,2组比较差异均有统计学意义(t=3.12、3.02,均P<0.05)。观察组并发症发生率为2.22%(1/45),显著低于对照组的15.56%(7/45),2组比较差异有统计学意义(χ^(2)=4.94,P<0.05)。结论小儿泌尿系统结石微创手术中应用协同护理结合医护一体化模式护理具有显著效果。Objective To explore the application of collaborative nursing combined with medical integration model in minimally invasive surgery for pediatric urinary calculi,to provide clinical guidance for minimally invasive surgical nursing of urinary calculi in children.Methods From December 2020 to July 2022,90 children who underwent minimally invasive surgery for urinary calculi in Children′s Hospital Affiliated to Zhejiang University Medicine College were selected as subjects by quasi experiment.According to the time sequence of enrollment,they were divided into observation group(n=45)and control group(n=45).The control group was given routine nursing mode nursing,and the observation group was given collaborative nursing combined with medical integration mode nursing.The clinical related indicators,pain,anxiety and complications were compared between the two groups.Results In the observation group,the operation time,the amount of bleeding during operation,the first time to get out of bed after operation,the rate of stone removal immediately after operation and the rate of stone removal 1 month after operation were(75.48±5.92)min,(168.75±17.28)ml,(6.12±1.05)h,84.44%(38/45)and 97.77%(44/45),respectively.The control group was(78.39±6.75)min,(178.30±19.25)ml,(6.84±1.23)h,64.44%(29/45)and 82.22%(37/45),respectively,the differences were statistically significant(t/χ^(2)=2.17,2.48,2.99,4.73,6.05,all P<0.05).The Face,legges,Activity,Cry,Consolability Behavioral Tool scores of the observation group at 1 d,3 d and 7 d after operation were 6.28±1.21,5.35±1.37 and 2.87±0.65,respectively,and those of the control group were 7.05±1.55,5.95±1.25 and 3.21±0.73,respectively,the differences were statistically significant(t=2.63,2.17,2.33,all P<0.05).The Modified Yale Preoperative Anxiety Scale and Frankl Compliance Scale Scores in the observation group at the day before discharge hospital were 55.28±5.52,3.60±0.40,while in the control group were 60.02±8.56,2.82±0.61,the differeces were significat(t=3.12,3.02,both P<0.0

关 键 词：护理 最小侵入性外科手术 医护一体化 小儿 泌尿结石 

分 类 号：R473.72[医药卫生—护理学]