基于循证理念的围术期护理在宫颈妊娠手术保守治疗患者中的应用  

Application of the evidence-based perioperative nursing for patients with cervical pregnancy who undergone the conservative surgery

作　　者：章淑媛 周满[1] 张晶[1] 余晓辉 ZHANG Shuyuan;ZHOU Man;ZHANG Jing;YU Xiaohui(Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu Province,210000)

机构地区：[1]南京医科大学附属妇产医院,南京妇幼保健院,210000

出　　处：《中国计划生育学杂志》2025年第3期651-655,661,共6页Chinese Journal of Family Planning

摘　　要：目的:分析基于循证理念的围术期护理在宫颈妊娠手术保守治疗患者中的应用效果。方法:选择2018年2月-2023年3月本院收治的拟行手术保守治疗的宫颈妊娠患者48例,按入院时间顺序分为循证组及常规组各24例。两组均给予常规围术期护理,循证组同时给予基于循证理念的围术期护理。比较两组入院时及术前生理应激[心率(HR)、呼吸频率(RR)、舒张压(DBP)、收缩压(SBP)]水平,术后恢复、术后疼痛视觉模拟量表(VAS)、自理能力Barthel指数量表(BI)评分及并发症情况。结果:干预后两组术前HR、RR、DBP、SBP水平均高于入院时,但循证组低于常规组,循证组住院时间(7.84±1.95d)、术后自行下床活动时间(27.91±2.86h)及月经恢复时间(23.24±3.08d)均短于较常规组(9.32±2.46d、33.58±3.65h、26.86±3.40d),术后2 h、6 h、12 h、24 h的VAS评分(3.04±0.52分、2.58±0.43分、1.70±0.28分、1.25±0.21分)均低于常规组,术后3 d的BI评分(89.70±6.38分)高于常规组(82.66±7.24分)(均P<0.05);两组并发症发生率(8.3%、20.8%)未见差异(P>0.05)。结论:基于循证理念的围术期护理可显著减轻宫颈妊娠手术保守治疗患者术前应激水平,降低术后疼痛程度,促进术后恢复,但对并发症发生率的影响有待进一步论证。Objective:To analyze the application effect of the evidence-based perioperative nursing for patients with cervical pregnancy who undergone the conservative surgery.Methods:48 patients with cervical pregnancy who wanted the conservative surgery were selected and were divided into study group(n=24)and control group(n=24)based on the chronological order of admission from February 2018 to March 2023.The patients in the two groups received the conventional perioperative nursing care,while the patients in the study group received the evidence-based perioperative nursing care additionally.The physiological stress evaluated by the heart rate(HR),the respiratory rate(RR),the diastolic blood pressure(DBP)and the systolic blood pressure(SBP)at admission and pre-operation,the postoperative recovery indicators values,the scores of postoperative pain evaluated by visual analogue scale(VAS)and the self-care ability evaluated by Barthel index(BI),and the complications rate of the patients were compared between the two groups.Results:After intervention,the values of HR,RR,DBP and SBP of the patients in the two groups before operation were significantly higher than those at admission,but which of the patients in the study group were significantly lower than those of the patients in the control group.The hospitalization time(7.84±1.95d),the time of the postoperative getting out of bed(27.91±2.86h)and the menstrual recovery time(23.24±3.08d)of the patients in the study group were significantly shorter than those(9.32±2.46d,33.58±3.65h and 26.86±3.40d)of the patients in the control group.The VAS scores of the patients in the study group at 2h,6h,12h and 24h after operation(3.04±0.52 points,2.58±0.43 points,1.70±0.28 points and 1.25±0.21 points)were significantly lower than those of the patients in the control group.The BI score(89.70±6.38 points)of the patients in the study group in 3 days after operation was significantly higher than that(82.66±7.24 points)of the patients in the control group(all P<0.05).There was no sig

关 键 词：宫颈妊娠 手术保守治疗 围术期护理 循证理念 应激水平 术后恢复 缓解疼痛 

分 类 号：R47[医药卫生—护理学]