医护一体化在胆道外引流患者居家诊疗中的应用观察  

Application observation of integrated medical care and nursing at home for patients with external biliary drainage

作　　者：丁卫萍 张蜀豫 祝李娜 吴苹苹 孙思雯 Ding Weiping;Zhang Shuyu;Zhu Lina;Wu Pingping;Sun Siwen(Department of Biliary Tract,The Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China;Department of HepatoSurgery,the Third Affiliated Hospital of Naval Medical University,Shanghai 201805,China)

机构地区：[1]海军军医大学第三附属医院胆道三科,上海200438 [2]海军军医大学第三附属医院肝外四科,上海201805

出　　处：《中华转移性肿瘤杂志》2024年第2期125-129,共5页Chinese Journal of Metastatic Cancer

基　　金：2020年海军军医大学第三附属医院护理科研基金资助项目(20HL007)。

摘　　要：目的探讨医护一体化延续性的管理模式对胆道恶性肿瘤患者行胆道外引流后居家治疗和护理的影响。方法收集2021年1月至2022年1月期间在我科行胆道外引流的恶性梗阻性黄疸患者104例,采用随机数字化量表法将之分为对照组与研究组,各52例。对照组行常规护理;研究组在常规护理的基础上,医护人员协同处理胆道引流管患者在居家治疗和护理中遇到的难题。比较两组患者对相关知识的需求程度,并发症的发生率,干预前、后自我健康管理能力量表(ESCA)评分以及对护理的满意度。结果两组患者对胆道引流管居家诊疗及护理相关知识的需求程度均较高,干预前ESCA评分结果相近(103.06∶105.50,t=0.59,P=0.557);干预后研究组ESCA评分以及对护理满意度均高于对照组(131.79∶111.48,t=48.53,P<0.001)。两组间并发症发生率差异有统计学意义趋势(17%∶6%,χ^(2)=3.39,P=0.066)。结论在胆道外引流患者的居家治疗和护理中应用医护一体化延续性的管理模式能有效缓解患者的负面情绪,提高自我管理的能力,减少胆道引流管并发症的发生率,提升护理满意度。Objective To explore the influence of continuous management mode of integrated medical care and nursing at home for patients with biliary malignant tumor after external biliary drainage.Methods A total of 104 patients with malignant obstructive jaundice who underwent external biliary drainage in our department from January 2021 to January 2022 were collected,and randomly divided into control group and research group with 52 cases in each group by digital scale method.The control group received routine treatment and nursing care.On the basis of routine nursing,the research group cooperated with medical staff to address the difficulties encountered by patients with biliary drainage tubes in home care.The need for relevant knowledge,the incidence of complications,the exercise of self-care agency score(ESCA score)with pre-and post-intervention,and the satisfaction with home care were compared between the two groups.Results The demand for home care knowledge related to biliary drainage tubes was high in both groups of patients,and there was no significant difference in ESCA scores before intervention(103.06 vs 105.50,t=0.59,P=0.557).After intervention,the ESCA score and nursing satisfaction of the research group were higher than those of the control group(131.79 vs 111.48,t=48.53,P<0.001),and there was a significant difference in the incidence of complications between the two groups(17%vs 6%,χ^(2)=3.39,P=0.066).Conclusion The application of continuous management mode of the integrated medical care and nursing at home for patients with external biliary drainage can effectively alleviate the negative emotions,improve the ability of self-management,reduce the incidence of complications of biliary drainage tube,and ameliorate treatment and nursing satisfaction.

关 键 词：医护一体化 胆道外引流 居家治疗和护理 并发症 满意度 

分 类 号：R473.2[医药卫生—护理学]