以创新扩散理论为指导的精细化管理在联合瓣膜病变患者围术期护理中的应用效果  

Application Effect of Fine Management Guided by the Innovation Diffusion Theory in Perioperative Nursing of Patients with Combined Valvular Lesion

作　　者：刘峥 程晶 许红凤 LIU Zheng;CHENG Jing;XU Hongfeng(Heart Center,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院心脏中心,北京市100020

出　　处：《实用心脑肺血管病杂志》2024年第12期124-128,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：北京市自然科学基金资助项目(7244348)。

摘　　要：目的探究以创新扩散理论为指导的精细化管理在联合瓣膜病变患者围术期护理中的应用效果。方法选取2023年5月—2024年1月在首都医科大学附属北京朝阳医院心脏中心治疗的联合瓣膜病变患者60例为研究对象,采用随机数字表法将其分为对照组和研究组,每组30例。对照组患者接受常规护理;研究组患者接受以创新扩散理论为指导的精细化管理,包括术前明确健康教育扩散内容、体位及药品管理,术中精细护理、意外管理,术后明确健康教育扩散内容及时间切点、早期活动管理、营养支持、并发症预防及护理。比较两组患者术前及术后3个月冠心病自我管理行为量表(CSMS)评分,手术情况(苏醒时间、术后气管插管留置时间、术后首次通便时间、术后引流管拔除时间)和住院时间,出院时6分钟步行距离(6MWD)和mini改良功能独立测量量表(mmFIM)评分,术前及术后3个月心功能指标〔左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)〕,术后并发症发生率。结果术后3个月,研究组患者CSMS评分高于对照组(P<0.05)。研究组患者苏醒时间、术后气管导管插管时间、术后首次通便时间、术后引流管拔除时间及住院时间均短于对照组(P<0.05)。出院时,研究组患者6MWD长于对照组,转移维度、行走维度评分高于对照组(P<0.05)。术后3个月,研究组患者LVEF高于对照组,LVEDD大于对照组(P<0.05)。研究组患者腹胀、压疮发生率低于对照组(P<0.05)。结论以创新扩散理论为指导的精细化管理能有效提升联合瓣膜病变患者自我管理能力,促进患者术后恢复,改善患者心功能,减少患者腹胀及压疮的发生。Objective To explore the application effect of fine management guided by the innovation diffusion theory in perioperative nursing of patients with combined valvular lesion.Methods A total of 60 patients with combined valvular lesion admitted to Beijing Chao-Yang Hospital,Capital Medical University from May 2023 to January 2024 were selected as the study subjects and divided into the control group and the study group by random number table method,with 30 cases in each group.Patients in the control group received routine care;patients in the study group received refined management guided by innovative diffusion theory,including preoperative clear health education on diffusion content,position and drug management,intraoperative refined care and accident management,postoperative diffusion health education content and diffusion time cut-off point,early activity management,nutritional support,complication prevention,and care.The Coronary Heart Disease Self-Management Behavior Scale(CSMS)scores before surgery and at 3 months after surgery,surgical conditions(awakening time,postoperative tracheal intubation retention time,postoperative first laxative time,postoperative drain removal time)and hospitalization time,the 6-minute walking distance(6MWD)and mini-modified Function Independent Measure(mmFIM)score at discharge,the indices of heart function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)]before surgery and at 3 months after surgery,and postperative complication rate were compared between the two groups.Results At 3 months after surgery,the CSMS scores in the study group were higher than those in the control group(P<0.05).The awakening time,postoperative tracheal intubation retention time,postoperative first laxative time,postoperative drain removal time,and hospitalization time in the study group were shorter than those in the control group(P<0.05).At discharge,patients in the study group had longer 6MWD and higher transfer dimension and walking dimension scores than the cont

关 键 词：心脏瓣膜疾病 联合瓣膜心脏手术 创新扩散理论 精细化管理 

分 类 号：R542.5[医药卫生—心血管疾病]