基于循证的综合护理干预在脊柱外科术后便秘病人中的应用研究  

Application evidence-based comprehensive nursing intervention in patients with constipation after spinal surgery

作　　者：罗琴 李艳婷[1] 莫雪晴 朱江丽[1] 罗艳娥[1] 周阳[1] LUO Qin;LI Yanting;MO Xueqing;ZHU Jiangli;LUO Yan′e;ZHOU Yang(Xiangya Hospital,Central South University,Hunan 410008 China)

机构地区：[1]中南大学湘雅医院,湖南410008

出　　处：《循证护理》2024年第23期4219-4223,共5页Chinese Evidence-Based Nursing

基　　金：湖南省社会科学基金重点项目,编号:23ZDB002。

摘　　要：目的:将脊柱外科术后病人便秘预防与管理的证据用于临床并评价效果。方法:通过证据检索和文献评价整合证据,结合临床情境确定审查指标和审查方法,分析障碍因素并制定行动策略。比较证据应用前后审查指标执行率、护士知识水平和病人结局指标。结果:证据应用后,10项审查指标由0~61.1%提高到57.5%~100.0%;护士相关知识得分由(51.50±13.19)分提高到(83.25±7.30)分,差异有统计学意义(P<0.05);脊柱外科术后病人便秘发生率由52.8%降至5.0%、术后腹胀腹痛发生率由69.4%降至12.5%、术后辅助药物使用率由86.1%降至55.0%,术后首次排便时间由(88.75±32.32)h缩短至(55.83±23.02)h,差异均有统计学意义(P<0.05)。结论:基于循证的脊柱外科术后病人便秘预防与管理方案,可提高专科护士的相关知识水平,降低便秘发生率,提高便秘护理质量。Objective:To evaluate the effects of the evidence on the prevention and management of constipation in patients after spinal surgery.Methods:Evidence was synthesised through evidence retrieval and literature evaluation,audit criteria and audit method were developed according to clinical situations.Obstacle factors were analysed and action strategies were developed.The implementation rate,knowledge level of nurses and outcome indicators of patients before and after the clinical practice were compared.Results:After evidence-based practice,10 audit criteria increased from 0-61.1%to 57.5%-100.0%.The level of nurses′knowledge score increased from(51.50±13.19)to(83.25±7.30),and the difference was statistically significant(P<0.05).The incidence of constipation decreased from 52.8%to 5.0%,the incidence of postoperative abdominal distension and pain decreased from 69.4%to 12.5%,the utilization rate of postoperative adjuvant drugs decreased from 86.1%to 55.0%,and the time of the first postoperative defecation decreased from(88.75±32.32)h to(55.83±23.02)h.All the differences were statistically significant(P<0.05).Conclusion:Evidence-based prevention and management of constipation in patients after spinal surgery can improve the level of nurses′knowledge,reduce the incidence of constipation,and enhance the quality of constipation management.

关 键 词：脊柱手术 便秘 循证护理 循证实践 

分 类 号：R473.6[医药卫生—护理学]