基于症状管理理论的精准护理模式在经括约肌间切除术后患者中的应用  

Application of precision care model based on symptom management theory for patients after intersphincteric resection

作　　者：殷燕[1] 张洁[2] 何文斌 段静 李思思[3] 江从庆[3] 解萧宇 胡小娜 谢慧瑄 骆曼 孙文 YIN Yan;ZHANG Jie;HE Wenbin;DUAN Jing;LI Sisi;JIANG Congqing;XIE Xiaoyu;HU Xiaona;XIE Huixuan;LUO Man;SUN Wen(Wound/Stoma Diagnosis and Treatment Center,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Retirement Office,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Colorectal&Anal Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院创面/造口诊疗中心,武汉430071 [2]武汉大学中南医院离退休工作处,武汉430071 [3]武汉大学中南医院结直肠肛门外科,武汉430071

出　　处：《医学新知》2024年第8期852-860,共9页New Medicine

基　　金：国家自然科学基金青年科学基金项目(82202915);武汉大学中南医院护理学科培育项目(HLXKPY202101)。

摘　　要：目的基于症状管理理论构建经括约肌间切除术后患者精准护理模式,评价其应用效果。方法采用非随机同期对照研究设计,前瞻性选取2023年6月至2024年3月在武汉大学中南医院结直肠肛门外科行经括约肌间切除术的患者为研究对象,按照入院时间先后分为对照组与试验组。对照组实施常规护理,试验组在常规护理的基础上实施基于症状管理理论的精准护理模式。比较两组患者术后肛门直肠功能、吻合口并发症发生率以及生活质量。结果共纳入111例患者,其中试验组56例,对照组55例。试验组患者术后肛门直肠功能优良率显著优于对照组(69.64%vs.34.55%,P<0.05),试验组在生活质量功能领域的躯体形象、体重、焦虑、性欲以及症状领域的尿频、便频、腹胀等方面得分均优于对照组(P<0.05),但两组在术后吻合口并发症发生率上差异无统计学意义(3.57%vs.10.91%,P>0.05)。结论基于症状管理理论的精准护理模式可以有效恢复经括约肌间切除术后患者的肛门直肠功能,提升患者术后生活质量。Objective To explore the effects of precision care model for patients after intersphincteric resection based on symptom management theory.Methods Patients with intersphincteric resection in the colorectal and anal surgery department of Zhongnan Hospital of Wuhan University from June 2023 to March 2024 were prospectively selected by nonrandomized concurrent controlled trail,and they were divided into the control group and the trial group according to the order of admission time.The control group received routine care,and the trial group received precision care model based on symptom management theory on the basis of the intervention in the control group.The anorectal function,anastomotic incidence and quality of life were compared between the two groups after intersphincteric resection.Results A total of 111 patients were enrolled in the study,with 56 in the trial group and 55 in the control group.The excellent rate of anorectal function in the trial group was significantly higher than that in the control group after surgery(69.64%vs.34.55%,P<0.05).The trial group scored better than the control group in the quality of life function domains of body image,weight,anxiety,and libido,and in the symptom domains of urinary frequency,frequency of defecation,abdominal distension and so on(P<0.05),but the difference between the two groups in the incidence of postoperative anastomotic complications was not statistically significant(3.57%vs.10.91%,P>0.05).Conclusion The precise care model based on symptom management theory can effectively restore the anorectal function of patients and improve the quality of life of patients after intersphincteric resection.

关 键 词：直肠癌 经括约肌间切除 吻合口 精准护理 症状管理理论 

分 类 号：R473.73[医药卫生—护理学]