基于循证理念的集束化护理干预在颅内动脉瘤栓塞术后患者中的应用  

Application of evidence-based concepts of intensive nursing intervention on intracranial aneurysm embolisation postoperation patients

作　　者：丁相云 程善红[1] 朱潇 庄倩倩 辛琳琳 DING Xiangyun;CHENG Shanhong;ZHU Xiao;ZHUANG Qianqian;XIN Linlin(Lianyungang Second People's Hospital,Lianyungang 222000,China)

机构地区：[1]连云港市第二人民医院神经外科,江苏省连云港市222000

出　　处：《护理实践与研究》2025年第4期599-605,共7页Nursing Practice and Research

基　　金：江苏省科技厅基础研究计划(编号:BK20201077)。

摘　　要：目的旨在评估循证医学支持下的集束化护理干预在改善颅内动脉瘤栓塞术后患者的疼痛管理和睡眠质量方面的有效性,同时观察其对患者焦虑、抑郁症状和躯体化症状的影响,以及对患者整体预后的改善。方法选取连云港市第二人民医院于2017年1月—2023年4月在神经外科收治的82例颅内动脉瘤患者作为研究对象,按照组间基线资料均衡可比的原则分为对照组和观察组,每组41例。对照组接受常规护理,观察组接受以循证为支持的集束化干预护理。采用阿森斯失眠量表(Athens Insomnia Scale,AIS)、视觉模拟评分(Visual Analogue Scale,VAS)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)、躯体化症状自评表(Symptom Checklist-90,SCL-90)、格拉斯哥预后评分(Glasgow Outcome Scale,GOS)对患者疼痛程度和睡眠质量、焦虑抑郁情绪、躯体症状及其预后情况进行比较。结果经过干预后,观察组患者睡眠质量评分、焦虑、抑郁评分及躯体症状评分均低于对照组,干预前观察组VAS评分高于对照组,干预24 h、干预72 h时观察组VAS评分均低于对照组(P组间<0.05)。两组患者随干预时间延长VAS评分均呈下降的趋势,时间之间差异有统计学意义(P时间<0.05);并且随观察时间延长,组间差异逐渐增大,组间随时间变化的差异有统计学意义(P交互<0.05)。格拉斯哥预后评分均高于对照组,差异均有统计学意义(P<0.05)。结论循证医学支持的集束化护理干预能改善颅内动脉瘤栓塞术后患者的疼痛、睡眠质量、焦虑抑郁症状以及预后情况,从而提高患者的总体治疗效果和生活质量。Objective To assess the effectiveness of the evidence-based medicine-supported intensive nursing intervention in improving pain management and sleep quality in patients after intracranial aneurysm embolisation,to observe the impact on patients’anxiety,depressive symptoms and somatisation symptoms and the improvement of patients'overall prognosis.Methods Eighty-two patients with intracranial aneurysms admitted to the neurosurgery department of the Lianyungang Second People's Hospital from January 2017 to April 2023 were selected as the study subjects,they were divided into a control group and an observation group in accordance with the principle of balanced and comparable baseline data between the groups,with 41 cases in each group.The control group received conventional nursing care,and the observation group received evidencebased support for intensive intervention nursing.The Athens Insomnia Scale(AIS),Visual Analogue Scale(VAS),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Symptom Checklist-90(SCL-90),and Glasgow Outcome Scale(GOS)were used to compare the patients'pain level and sleep quality,anxiety and depression,somatic symptoms and their prognosis.Results After the intervention,patients in the observation group shown lower sleep quality scores,anxiety and depression scores,and somatic symptom scores than those in the control group,and the VAS scores in the observation group were higher than those in the control group before the intervention,and the VAS scores in the observation group were lower than those in the control group at 24 h and 72 h of the intervention(P<0.05).The VAS scores showed a decreasing trend with the extend of intervention time,the diff erence between times was statistically signifi cant(P<0.05),the diff erence between groups gradually increased with the prolongation of observation time,and the diff erence between groups over time was statistically signifi cant(P<0.05).The Glasgow prognostic scores were all higher than those of the control group,and the differences we

关 键 词：颅内动脉瘤栓塞术 集束化护理干预 疼痛管理 睡眠质量 预后情况 

分 类 号：R473.73[医药卫生—护理学]