基于微信平台的延续性护理在肥胖合并胃食管反流病患者术后自我管理中的临床应用  

Clinical application value of continuous nursing based on WeChat platform in self-management of obese patients with gastroesophageal reflux disease after operation

作　　者：闫晶[1] 韩琦[2] 蒋媛[1] Yan Jing;Han Qi;Jiang Yuan(Department of Minimally Invasive,Hernia and Abdominal Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Central Operating Room,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院微创、疝与腹壁外科,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院中心手术室,乌鲁木齐830001

出　　处：《中华胃食管反流病电子杂志》2023年第4期216-221,共6页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

基　　金：新疆维吾尔自治区人民医院院内项目(20210245)。

摘　　要：目的探讨基于微信平台的延续性护理在肥胖合并胃食管反流病患者术后自我管理中的临床应用。方法选取2021年10月至2023年3月在新疆维吾尔自治区人民医院微创、疝与腹壁外科住院并且行袖状胃切除联合胃底折叠手术的115例肥胖合并胃食管反流病患者,随机分为对照组(40例)和试验组(75例)。对照组出院时进行常规术后饮食、药物指导和电话随访;试验组在对照组的基础上应用微信平台的延续性护理服务。比较2组患者术后自我管理情况的差异。采用多因素logistic回归分析袖状胃切除联合胃底折叠手术术后1个月内非计划再入院的的危险因素。结果术后复查时发现试验组患者术后1个月内非计划再入院情况(9.3%比27.5%,P=0.011)以及因为呕吐(8.0%比22.5%,P=0.028)、低钾血症(9.3%比25.0%,P=0.024)非计划再入院情况均小于对照组。单因素和多因素的Logistic回归分析发现术后未进行基于微信平台的延续性护理是术后1个月内非计划再入院的危险因素(P<0.05)。结论基于微信平台的延续性护理在袖状胃切除联合胃底折叠手术术后患者自我管理中具有一定的临床应用价值。Objective To explore the clinical application value of continuous nursing based on WeChat platform in self-management of obese patients with gastroesophageal reflux disease after operation.Methods A total of 115 obese patients with gastroesophageal reflux disease who were hospitalized in the Department of minimally invasive,hernia and abdominal wall surgery and underwent sleeve gastrectomy combined with fundoplication in the People's Hospital of Xinjiang Uyghur Autonomous Region from October 2021 to March 2023 were selected and randomly divided into control group(n=40)and test group(n=75).In which,the control group was discharged with routine postoperative diet,medication and telephone follow-up,while the test group was given a continuing nursing service using wechat platform on the basis of the control group.Postoperative self-management was compared between the two groups.Multivariate logistic regression was used to analyze the risk factors for readmission within 1 month after sleeve gastrectomy combined with fundoplication.Results One month after operation,it was found that the unplanned readmission within one month after operation(9.3%vs 27.5%,P=0.011)and unplanned readmission due to vomiting(8.0%vs 22.5%,P=0.028)and hypokalemia(9.3%vs 25.0%,P=0.024)were lower than those in the control group.Univariate and multivariate Logistic regression analysis showed that the risk factor of unplanned readmission within one month after operation was the lack of continuous nursing based on WeChat platform(P<0.05).Conclusion Continuous nursing based on Wechat platform has certain clinical application value in self-management of patients after sleeve gastrectomy combined with fundoplication.

关 键 词：微信平台 延续性护理 肥胖症 胃食管反流病 袖状胃切除联合胃底折叠术 自我管理 临床应用价值 

分 类 号：R571[医药卫生—消化系统]