循证护理在肾脏铸型感染性结石患者围术期的应用效果
|
摘要
目的:探讨循证护理在肾脏铸型感染性结石患者围术期的应用效果。方法:选取2015年2月至2017年1月在海南省人民医院接受经皮肾镜取石术治疗的肾脏铸型感染性结石患者136例,将2015年2月至2016年1月的68例患者纳入对照组,予以常规护理;将2016年2月至2017年1月的68例患者纳入研究组,予以循证护理。护理结束后比较两组术后疼痛程度和心理健康状况,同时记录两组患者对术后疼痛控制满意度和术后并发症发生情况。结果:术后24,72 h研究组疼痛评分均较对照组明显降低(P<0.05);两组患者护理后SAS,SDS评分均较护理前降低,且研究组降低程度明显大于对照组(P<0.05);研究组疼痛控制满意度明显优于对照组(P<0.05);研究组术后并发症发生率(22.06%)明显低于对照组(75.00%,P<0.05)。结论:循证护理的实施可有效减轻患者的术后疼痛程度和焦虑抑郁程度,提高患者对疼痛控制的满意度,降低术后并发症的发生率。
Objective: To investigate the application effect of evidence-based nursing in patients with renal struvite staghorn calculi. Methods: A total of 136 cases of kidney cast infectious stones treated by percutaneous nephrolithotomy in our hospital from February 2015 to January 2017 were selected, and 68 patients from February 2015 to January 2016 were included in the control group and received routine nursing care; 68 patients from February 2016 to January 2017 were included in the study group and received evidence-based nursing and. After the end of nursing, the pain and mental health status of the two groups were compared, and the satisfaction of postoperative pain control and postoperative complications of the two groups were recorded and compared. Results: The scores of pain in study group at 24 and 72 h after operation were significantly lower than those in control group(P<0.05); the SAS and SDS scores of both groups decreased after nursing, and the reduction level in study group was more significant than that in control group(P<0.05); the satisfaction degree of pain management in the study group was significantly better than that in the control group(P<0.05); the incidence of postoperative complications in the study group was significantly lower than that in the control group(22.06% vs 75.00%, P<0.05). Conclusion: The implementation of evidence-based nursing can effectively reduce the postoperative pain, anxiety and depression degrees, and improve the satisfaction degree of pain management, and reduce postoperative complications.
Objective: To investigate the application effect of evidence-based nursing in patients with renal struvite staghorn calculi. Methods: A total of 136 cases of kidney cast infectious stones treated by percutaneous nephrolithotomy in our hospital from February 2015 to January 2017 were selected, and 68 patients from February 2015 to January 2016 were included in the control group and received routine nursing care; 68 patients from February 2016 to January 2017 were included in the study group and received evidence-based nursing and. After the end of nursing, the pain and mental health status of the two groups were compared, and the satisfaction of postoperative pain control and postoperative complications of the two groups were recorded and compared. Results: The scores of pain in study group at 24 and 72 h after operation were significantly lower than those in control group(P<0.05); the SAS and SDS scores of both groups decreased after nursing, and the reduction level in study group was more significant than that in control group(P<0.05); the satisfaction degree of pain management in the study group was significantly better than that in the control group(P<0.05); the incidence of postoperative complications in the study group was significantly lower than that in the control group(22.06% vs 75.00%, P<0.05). Conclusion: The implementation of evidence-based nursing can effectively reduce the postoperative pain, anxiety and depression degrees, and improve the satisfaction degree of pain management, and reduce postoperative complications.
引文
1.刘迎春,熊国英,龙国利,等.循证护理对经皮内镜下胃造瘘术后肠内营养及并发症的干预效果[J].中华现代护理杂志,2016,22(7):909-912.LIU Yingchun,XIONG Guoying,LONG Guoli,et al.Intervention effects of evidence-based nursing on enteral nutrition and complications of patients after PEG[J].Chinese Journal of Modern Nursing,2016,22(7):909-912.
2 .卢东,蒋小雷,吴明辉,等.经皮肾镜超声吸附碎石术对感染性肾结石患者炎症介质及应激激素的影响研究[J].海南医学院学报,2016,22(7):680-682.LU Dong,JIANG Xiaolei,WU Minghui,et al.Effects of ultrasonic adsorption lithotripsy by percutaneous nephroscope on inflammation mediators and stress hormones in patients with infectious renal calculi[J].Journal of Hainan Medical University,2016,22(7):680-682.
3 .徐毅,童炎岳,雷樟明,等.经皮肾镜超声碎石术在感染性肾结石中的疗效及对患者应激激素的影响观察[J].中华医院感染学杂志,2017,27(6):1309-1312.XU Yi,TONG Yanyue,LEI Zhangming,et al.Effect of percutaneous nephrolithotomy with ultrasound lithotripsy on infective renal calculi[J].Chinese Journal of Nosocomiolog y,2017,27(6):1309-1312.
4 .Yao L,Young N,Liu H,et al.Evidence for preoperative aspirin improving major outcomes in patients with chronic kidney disease undergoing cardiac surger y:a cohort study[J].Ann Surg,2015,261(1):207-212.
5 .童红芹.循证护理在胆囊结石患者术后疼痛护理中的应用[J].中国社区医师,2015,31(28):140-141.TONG Hongqin.Application of evidence-based nursing in postoperative pain nursing for patients with gallbladder stones[J].Chinese Community Doctors,2015,31(28):140-141.
6 .邱晓辉,李笑楠.循证护理在肾结石患者护理中的应用[J].中国现代药物应用,2013,7(3):105-106.QIU Xiaohui,LI Xiaonan.Application of evidence-based nursing in nursing of renal calculi patients[J].Chinese Journal of Modern Drug Application,2013,7(3):105-106.
7 .王敬斋,张树荣.Zung焦虑抑郁自评量表对消化内科门诊患者焦虑抑郁的测评[J].临床消化病杂志,2016,28(3):150-153.WANG Jingzhai,ZHANG Shurong.Assessment of anx iety and depression in gastrointestinal outpatients by Zung self-rating anxiety and depression scale[J].Chinese Journal of Clinical Gastroenterology,2016,28(3):150-153.
8 .梁姣,王晓娟,刘玉姣,等.急诊老年患者腹腔镜胆囊术应用循证护理干预的效果观察[J].新疆医科大学学报,2016,39(7):919-922.LIANG Jiao,WANG Xiaojuan,LIU Yujiao,et al.Effect of the implementation of ev idence-based nursing inter vention in the treatment of elderly patients with acute cholecystitis by laparoscopic operation[J].Journal of Xinjiang Medical University,2016,39(7):919-922.
9 .杜爱华.预见性护理联合循证护理对手术室护理质量及患者满意度的影响[J].中华现代护理杂志,2016,22(6):845-847.DU Aihua.Influences of foresight nursing combined with evidencebased nursing on the quality of Operating Room nursing and patient’s satisfaction[J].Chinese Journal of Modern Nursing,2016,22(6):845-847.
10 .陈婕妤,顾伶俐,毛海英,等.循证护理对腹腔镜子宫切除术患者术后尿潴留的预防效果[J].实用临床医药杂志,2017,21(22):67-69.CHEN Jieyu,GU Lingli,MAO Haiying,et al.Effect of evidence-based nursing on postoperative urinary retention in patients undergoing laparoscopic hysterectomy[J].Journal of Clinical Medicine in Practice,2017,21(22):67-69.
11 .许艳,倪永梁.膀胱造瘘术后应用循证护理预防造瘘口感染的效果评价[J].中国煤炭工业医学杂志,2016,18(8):1220-1223.XU Yan,NI Yongliang.The effect of evidence-based nursing on preventing stoma infection after cystostomy[J].Chinese Journal of Coal Industry Medicine,2016,18(8):1220-1223.
12 .刘荣新,曹信宇,杨金丽,等.输尿管软镜钬激光治疗肾铸型结石效果及应用技巧[J].现代仪器与医疗,2017,23(1):40-42.LIU Rongxin,CAO Xinyu,YANG Jinli,et al.Effect and application skills of flexible ureteroscope holmium laser in the treatment of renal cast stones[J].Modern Instruments&Medical Treatment,2017,23(1):40-42.
13 .Stern JM,Moazami S,Qiu Y,et al.Ev idence for a distinct gut microbiome in kidney stone formers compared to non-stone formers[J].Urolithiasis,2016,44(5):399-407.
14.徐峰.以循证护理为基础的临床护理服务体系的建立及应用研究[J].中国药物与临床,2016,16(6):927-928.XU Feng.Establishment and application of clinical nursing service system based on evidence-based nursing[J].Chinese Remedies&Clinics,2016,16(6):927-928.
15 .王珩,孙晓青,王军起,等.经皮肾镜超声碎石清石术两种不同探针治疗肾铸型结石比较研究[J].徐州医学院学报,2016,36(5):321-324.WANG Heng,SUN Xiaoqing,WANG Junqi,et al.A clinical comparative study of point contact probes and plane probes in percutaneous nephrolithotomy for treatment of staghorn renal calculi[J].Acta Academia Medicine Xuzhou,2016,36(5):321-324.
16 .靳英辉,商洪才,唐琪,等.我国循证护理实践证据在临床应用的研究进展[J].中国实用护理杂志,2015,31(29):2249-2252.JIN Yinghui,SHANG Hongcai,TANG Qi,et al.Research progress of evidence-based nursing practice evidence in clinical practice in China[J].Chinese Journal of Practical Nursing,2015,31(29):2249-2252.
17 .张艳琴.循证护理提高泌尿科术后患者疼痛控制满意度[J].护理学杂志,2013,28(16):40-42.ZHANG Yanqin.Evidence-based nursing improves satisfaction with pain control in patients after urinary surgery[J].Journal of Nursing Science,2013,28(16):40-42.
18 .庞松强,罗功唐,宋瑶.经皮肾镜钬激光碎石术治疗肾铸型结石疗效观察[J].新乡医学院学报,2015,32(8):768-769.PANG Songqiang,LUO Gongtang,SONG Yao.Effect of percutaneous nephroscope holmium laser lithotripsy in treatment of kidney staghorn stone[J].Journal of Xinxiang Medical University,2015,32(8):768-769.
19 .柴育农.肾结石患者护理中循证护理的应用[J].中国继续医学教育,2015,7(23):254-255.CHAI Yunong.Application of evidence-based nursing in nursing of patients with renal calculi[J].China Continuing Medical Education,2015,7(23):254-255.
20 .石庆敏.基于循证理论的疼痛护理对输尿管结石微创手术患者术后疼痛及康复的影响[J].中国医刊,2017,52(11):72-75.SHI Qingmin.Effects of pain nursing based on evidence-based theory on postoperative pain and rehabilitation for patients with ureteral calculi received minimally invasive surgery[J].Chinese Journal of Medicine,2017,52(11):72-75.
2 .卢东,蒋小雷,吴明辉,等.经皮肾镜超声吸附碎石术对感染性肾结石患者炎症介质及应激激素的影响研究[J].海南医学院学报,2016,22(7):680-682.LU Dong,JIANG Xiaolei,WU Minghui,et al.Effects of ultrasonic adsorption lithotripsy by percutaneous nephroscope on inflammation mediators and stress hormones in patients with infectious renal calculi[J].Journal of Hainan Medical University,2016,22(7):680-682.
3 .徐毅,童炎岳,雷樟明,等.经皮肾镜超声碎石术在感染性肾结石中的疗效及对患者应激激素的影响观察[J].中华医院感染学杂志,2017,27(6):1309-1312.XU Yi,TONG Yanyue,LEI Zhangming,et al.Effect of percutaneous nephrolithotomy with ultrasound lithotripsy on infective renal calculi[J].Chinese Journal of Nosocomiolog y,2017,27(6):1309-1312.
4 .Yao L,Young N,Liu H,et al.Evidence for preoperative aspirin improving major outcomes in patients with chronic kidney disease undergoing cardiac surger y:a cohort study[J].Ann Surg,2015,261(1):207-212.
5 .童红芹.循证护理在胆囊结石患者术后疼痛护理中的应用[J].中国社区医师,2015,31(28):140-141.TONG Hongqin.Application of evidence-based nursing in postoperative pain nursing for patients with gallbladder stones[J].Chinese Community Doctors,2015,31(28):140-141.
6 .邱晓辉,李笑楠.循证护理在肾结石患者护理中的应用[J].中国现代药物应用,2013,7(3):105-106.QIU Xiaohui,LI Xiaonan.Application of evidence-based nursing in nursing of renal calculi patients[J].Chinese Journal of Modern Drug Application,2013,7(3):105-106.
7 .王敬斋,张树荣.Zung焦虑抑郁自评量表对消化内科门诊患者焦虑抑郁的测评[J].临床消化病杂志,2016,28(3):150-153.WANG Jingzhai,ZHANG Shurong.Assessment of anx iety and depression in gastrointestinal outpatients by Zung self-rating anxiety and depression scale[J].Chinese Journal of Clinical Gastroenterology,2016,28(3):150-153.
8 .梁姣,王晓娟,刘玉姣,等.急诊老年患者腹腔镜胆囊术应用循证护理干预的效果观察[J].新疆医科大学学报,2016,39(7):919-922.LIANG Jiao,WANG Xiaojuan,LIU Yujiao,et al.Effect of the implementation of ev idence-based nursing inter vention in the treatment of elderly patients with acute cholecystitis by laparoscopic operation[J].Journal of Xinjiang Medical University,2016,39(7):919-922.
9 .杜爱华.预见性护理联合循证护理对手术室护理质量及患者满意度的影响[J].中华现代护理杂志,2016,22(6):845-847.DU Aihua.Influences of foresight nursing combined with evidencebased nursing on the quality of Operating Room nursing and patient’s satisfaction[J].Chinese Journal of Modern Nursing,2016,22(6):845-847.
10 .陈婕妤,顾伶俐,毛海英,等.循证护理对腹腔镜子宫切除术患者术后尿潴留的预防效果[J].实用临床医药杂志,2017,21(22):67-69.CHEN Jieyu,GU Lingli,MAO Haiying,et al.Effect of evidence-based nursing on postoperative urinary retention in patients undergoing laparoscopic hysterectomy[J].Journal of Clinical Medicine in Practice,2017,21(22):67-69.
11 .许艳,倪永梁.膀胱造瘘术后应用循证护理预防造瘘口感染的效果评价[J].中国煤炭工业医学杂志,2016,18(8):1220-1223.XU Yan,NI Yongliang.The effect of evidence-based nursing on preventing stoma infection after cystostomy[J].Chinese Journal of Coal Industry Medicine,2016,18(8):1220-1223.
12 .刘荣新,曹信宇,杨金丽,等.输尿管软镜钬激光治疗肾铸型结石效果及应用技巧[J].现代仪器与医疗,2017,23(1):40-42.LIU Rongxin,CAO Xinyu,YANG Jinli,et al.Effect and application skills of flexible ureteroscope holmium laser in the treatment of renal cast stones[J].Modern Instruments&Medical Treatment,2017,23(1):40-42.
13 .Stern JM,Moazami S,Qiu Y,et al.Ev idence for a distinct gut microbiome in kidney stone formers compared to non-stone formers[J].Urolithiasis,2016,44(5):399-407.
14.徐峰.以循证护理为基础的临床护理服务体系的建立及应用研究[J].中国药物与临床,2016,16(6):927-928.XU Feng.Establishment and application of clinical nursing service system based on evidence-based nursing[J].Chinese Remedies&Clinics,2016,16(6):927-928.
15 .王珩,孙晓青,王军起,等.经皮肾镜超声碎石清石术两种不同探针治疗肾铸型结石比较研究[J].徐州医学院学报,2016,36(5):321-324.WANG Heng,SUN Xiaoqing,WANG Junqi,et al.A clinical comparative study of point contact probes and plane probes in percutaneous nephrolithotomy for treatment of staghorn renal calculi[J].Acta Academia Medicine Xuzhou,2016,36(5):321-324.
16 .靳英辉,商洪才,唐琪,等.我国循证护理实践证据在临床应用的研究进展[J].中国实用护理杂志,2015,31(29):2249-2252.JIN Yinghui,SHANG Hongcai,TANG Qi,et al.Research progress of evidence-based nursing practice evidence in clinical practice in China[J].Chinese Journal of Practical Nursing,2015,31(29):2249-2252.
17 .张艳琴.循证护理提高泌尿科术后患者疼痛控制满意度[J].护理学杂志,2013,28(16):40-42.ZHANG Yanqin.Evidence-based nursing improves satisfaction with pain control in patients after urinary surgery[J].Journal of Nursing Science,2013,28(16):40-42.
18 .庞松强,罗功唐,宋瑶.经皮肾镜钬激光碎石术治疗肾铸型结石疗效观察[J].新乡医学院学报,2015,32(8):768-769.PANG Songqiang,LUO Gongtang,SONG Yao.Effect of percutaneous nephroscope holmium laser lithotripsy in treatment of kidney staghorn stone[J].Journal of Xinxiang Medical University,2015,32(8):768-769.
19 .柴育农.肾结石患者护理中循证护理的应用[J].中国继续医学教育,2015,7(23):254-255.CHAI Yunong.Application of evidence-based nursing in nursing of patients with renal calculi[J].China Continuing Medical Education,2015,7(23):254-255.
20 .石庆敏.基于循证理论的疼痛护理对输尿管结石微创手术患者术后疼痛及康复的影响[J].中国医刊,2017,52(11):72-75.SHI Qingmin.Effects of pain nursing based on evidence-based theory on postoperative pain and rehabilitation for patients with ureteral calculi received minimally invasive surgery[J].Chinese Journal of Medicine,2017,52(11):72-75.