针对性护理对腹腔镜治疗宫外孕患者手术指标的影响
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摘要
目的:探讨针对性护理对腹腔镜治疗宫外孕患者手术指标的影响。方法:选择2017年2月-2018年2月在本院采用腹腔镜手术治疗的宫外孕患者60例,根据护理方法不同分为对照组(n=30)和观察组(n=30)。对照组给予腹腔镜手术围术期常规护理,观察组在此基础上进行针对性护理。记录并比较两组手术时长、术中出血量、首次下床活动时间、留置导尿管时间、肛门排气时间及住院时间各手术指标;采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对患者的焦虑、抑郁等情绪进行评估,比较两组护理前后的心理状况;记录并统计两组胃肠道不适、尿路感染、皮下气肿、切口感染各并发症发生情况,比较两组护理效果。结果:观察组手术时长、术中出血量及留置导尿管时间与对照组比较,差异均无统计学意义(P>0.05);观察组首次下床活动时间、肛门排气时间及住院时间均较对照组更短,差异均有统计学意义(P<0.05);两组护理后SDS和SAS评分均低于护理前,差异均有统计学意义(P<0.05),其中观察组SDS和SAS评分均低于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:对行腹腔镜手术治疗的宫外孕患者采用针对性护理,能有效改善其心理状况,减少并发症发生,从而加快其康复速度,缩短住院时间,值得推广应用。
Objective:To explore the effect of targeted nursing on surgical index of laparoscopic treatment of ectopic pregnancy.Method:Sixty patients with ectopic pregnancy who underwent laparoscopic surgery in our hospital from February 2017 to February 2018 were selected and divided into a control group(n=30)and an observation group(n=30)according to different nursing methods.The control group was given routine care during laparoscopic surgery,and the observation group was given targeted care.The surgical duration,blood loss during surgery,the first time out of bed activity,indwelling catheter time,anal exhaust time and length of stay of the two groups were recorded and compared;the patient's anxiety,depression and other emotions were evaluated,and psychological status before and after nursing by self-rating anxiety scale(SAS),self-rating depression scale(SDS)were compared;the statistics of complications such as gastrointestinal discomfort,urinary tract infection,subcutaneous emphysema,and incision infection were compared between the two groups.Result:There were no significant differences in the length of operation,intraoperative blood loss,and indwelling catheter time between the observation group and the control group(P>0.05).The first time of getting out of bed,time of anal exhaust and time of hospitalization in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).After nursing,SDS and SAS scores in both groups were lower than those before nursing(P<0.05),SDS and SAS scores in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Laparoscopic surgery for ectopic pregnancy patients with targeted care,can effectively improve their psychological status,reduce complications,thereby accelerating the speed of recovery,shorten the length of stay,it is worth promoting.
Objective:To explore the effect of targeted nursing on surgical index of laparoscopic treatment of ectopic pregnancy.Method:Sixty patients with ectopic pregnancy who underwent laparoscopic surgery in our hospital from February 2017 to February 2018 were selected and divided into a control group(n=30)and an observation group(n=30)according to different nursing methods.The control group was given routine care during laparoscopic surgery,and the observation group was given targeted care.The surgical duration,blood loss during surgery,the first time out of bed activity,indwelling catheter time,anal exhaust time and length of stay of the two groups were recorded and compared;the patient's anxiety,depression and other emotions were evaluated,and psychological status before and after nursing by self-rating anxiety scale(SAS),self-rating depression scale(SDS)were compared;the statistics of complications such as gastrointestinal discomfort,urinary tract infection,subcutaneous emphysema,and incision infection were compared between the two groups.Result:There were no significant differences in the length of operation,intraoperative blood loss,and indwelling catheter time between the observation group and the control group(P>0.05).The first time of getting out of bed,time of anal exhaust and time of hospitalization in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).After nursing,SDS and SAS scores in both groups were lower than those before nursing(P<0.05),SDS and SAS scores in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Laparoscopic surgery for ectopic pregnancy patients with targeted care,can effectively improve their psychological status,reduce complications,thereby accelerating the speed of recovery,shorten the length of stay,it is worth promoting.
引文
[1]谢萍.围术期综合护理措施在宫外孕患者腹腔镜手术中的应用[J].实用临床医药杂志,2017,21(14):119-122.
[2]Zhang D,Chen A,Gu Y.Ruptured secondary abdominal pregnancy after primary laparoscopic treatment for tubal pregnancy:a case report[J].Medicine,2017,96(50):e9254.
[3]习玲.综合护理在腹腔镜下治疗宫外孕围手术期中的应用效果分析[J].中国医学创新,2017,14(30):83-85.
[4]李晓梅.宫外孕患者腹腔镜术围术期护理体会[J].实用临床医药杂志,2016,20(8):196.
[5]Ansari A,Ahmad S,James J A,et al.Robotic-assisted laparoscopic resection of cornual ectopic pregnancy.A case report[J].Journal of Reproductive Medicine,2015,60(1-2):58.
[6]王立芹,任新萍,王艳,等.系统心理干预对宫外孕腹腔镜手术患者心理状态及术后恢复的影响[J].国际精神病学杂志,2017,44(4):729-731.
[7]Uludag S Z,Kutuk M S,Dolanbay M,et al.Primary ovarian monochorionic twin ectopic pregnancy:A case report[J].Journal of Reproductive Medicine,2016,61(5):516-518.
[8]吴静,陈欢,倪亚男,等.交流技巧对宫外孕腹腔镜手术患者负性情绪及术后康复的影响[J].国际精神病学杂志,2015,42(2):72-75.
[9]Karayalcin R,Ozcan S,Tokmak A,et al.Pregnancy outcome of laparoscopic tubal reanastomosis:retrospective results from a single clinical centre[J].Journal of International Medical Research,2017,45(3):1245-1252.
[10]Dreyer K,Lier M C I,Emanuel M H,et al.Hysteroscopic proximal tubal occlusion versus laparoscopic salpingectomy as a treatment for hydrosalpinges prior to IVF or ICSI:an RCT[J].Human Reproduction,2016,31(9):dew050.
[11]李中学,孙强,姜威宏,等.后腹腔镜输尿管切开取石术与经输尿管镜取石术治疗老年上尿路结石患者的疗效及对炎症应激指标的影响[J].中国老年学杂志,2016,36(15):3763-3765.
[12]杨立新,马凤巧,王阳,等.后腹腔镜与输尿管镜技术治疗感染性输尿管上段结石患者后对其肾功能及其相关指标的影响[J].中华医院感染学杂志,2017,27(1):143-146.
[13]杨力,侯军,吕艳文.腹腔镜辅助下肌瘤剔除术对患者抗穆勒氏管激素及免疫功能的影响[J].中国内镜杂志,2017,23(11):63-67.
[14]莫波,马娟,郝志楠,等.结肠癌应用腹腔镜以及开腹手术治疗对机体免疫功能的影响比较[J].中国内镜杂志,2016,22(6):24-26.
[15]Thephile N,吴海福,施晨晔,等.腹腔镜与开腹手术治疗胃肠间质瘤的疗效分析及不同危险度对患者预后的影响[J].中华消化外科杂志,2016,15(9):882-887.
[16]李锦芳,林建玲,邓洁娜,等.多学科合作快速康复外科护理在腹腔镜异位妊娠手术中的应用[J].中国医学创新,2017,14(31):81-84.
[17]杨雪梅,苏光,邓春霞.循证护理在腹腔镜下输卵管异位妊娠术后的应用[J].河北医学,2016,22(8):1375-1377.
[18]郑燕敏,王静,王晓东.希望理论在宫外孕患者心理护理中的应用[J].武警后勤学院学报(医学版),2015,24(12):984-986.
[19]陈翠红.腹腔镜手术联合甲氨蝶呤治疗异位妊娠的临床研究[J].中国妇幼保健,2017,32(22):5781-5784.
[20]陈洁,江源,周怀君,等.腹腔镜手术治疗宫内妊娠合并输卵管妊娠的临床效果分析[J].中国妇幼保健,2017,32(15):3658-3661.
[2]Zhang D,Chen A,Gu Y.Ruptured secondary abdominal pregnancy after primary laparoscopic treatment for tubal pregnancy:a case report[J].Medicine,2017,96(50):e9254.
[3]习玲.综合护理在腹腔镜下治疗宫外孕围手术期中的应用效果分析[J].中国医学创新,2017,14(30):83-85.
[4]李晓梅.宫外孕患者腹腔镜术围术期护理体会[J].实用临床医药杂志,2016,20(8):196.
[5]Ansari A,Ahmad S,James J A,et al.Robotic-assisted laparoscopic resection of cornual ectopic pregnancy.A case report[J].Journal of Reproductive Medicine,2015,60(1-2):58.
[6]王立芹,任新萍,王艳,等.系统心理干预对宫外孕腹腔镜手术患者心理状态及术后恢复的影响[J].国际精神病学杂志,2017,44(4):729-731.
[7]Uludag S Z,Kutuk M S,Dolanbay M,et al.Primary ovarian monochorionic twin ectopic pregnancy:A case report[J].Journal of Reproductive Medicine,2016,61(5):516-518.
[8]吴静,陈欢,倪亚男,等.交流技巧对宫外孕腹腔镜手术患者负性情绪及术后康复的影响[J].国际精神病学杂志,2015,42(2):72-75.
[9]Karayalcin R,Ozcan S,Tokmak A,et al.Pregnancy outcome of laparoscopic tubal reanastomosis:retrospective results from a single clinical centre[J].Journal of International Medical Research,2017,45(3):1245-1252.
[10]Dreyer K,Lier M C I,Emanuel M H,et al.Hysteroscopic proximal tubal occlusion versus laparoscopic salpingectomy as a treatment for hydrosalpinges prior to IVF or ICSI:an RCT[J].Human Reproduction,2016,31(9):dew050.
[11]李中学,孙强,姜威宏,等.后腹腔镜输尿管切开取石术与经输尿管镜取石术治疗老年上尿路结石患者的疗效及对炎症应激指标的影响[J].中国老年学杂志,2016,36(15):3763-3765.
[12]杨立新,马凤巧,王阳,等.后腹腔镜与输尿管镜技术治疗感染性输尿管上段结石患者后对其肾功能及其相关指标的影响[J].中华医院感染学杂志,2017,27(1):143-146.
[13]杨力,侯军,吕艳文.腹腔镜辅助下肌瘤剔除术对患者抗穆勒氏管激素及免疫功能的影响[J].中国内镜杂志,2017,23(11):63-67.
[14]莫波,马娟,郝志楠,等.结肠癌应用腹腔镜以及开腹手术治疗对机体免疫功能的影响比较[J].中国内镜杂志,2016,22(6):24-26.
[15]Thephile N,吴海福,施晨晔,等.腹腔镜与开腹手术治疗胃肠间质瘤的疗效分析及不同危险度对患者预后的影响[J].中华消化外科杂志,2016,15(9):882-887.
[16]李锦芳,林建玲,邓洁娜,等.多学科合作快速康复外科护理在腹腔镜异位妊娠手术中的应用[J].中国医学创新,2017,14(31):81-84.
[17]杨雪梅,苏光,邓春霞.循证护理在腹腔镜下输卵管异位妊娠术后的应用[J].河北医学,2016,22(8):1375-1377.
[18]郑燕敏,王静,王晓东.希望理论在宫外孕患者心理护理中的应用[J].武警后勤学院学报(医学版),2015,24(12):984-986.
[19]陈翠红.腹腔镜手术联合甲氨蝶呤治疗异位妊娠的临床研究[J].中国妇幼保健,2017,32(22):5781-5784.
[20]陈洁,江源,周怀君,等.腹腔镜手术治疗宫内妊娠合并输卵管妊娠的临床效果分析[J].中国妇幼保健,2017,32(15):3658-3661.