循证护理在胸腔镜肺减容术患者中的应用
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摘要
目的探讨循证护理在胸腔镜肺减容术(LVRS)患者围术期中的应用效果。方法选择2016年1月至2018年1月在我院行胸腔镜肺减容术治疗的肺气肿患者82例作为研究对象,随机等分为对照组和观察组,对照组采用肺减容术常规护理,观察组采用循证护理解决肺减容术患者围术期较易出现的身心问题。比较两组患者术前、出院前1 d肺功能指标、运动能力指标及舒适度评分变化;统计两组患者住院时间、机械通气拔管时间、术后并发症发生情况。结果出院前两组患者肺功能指标(VC,FVC1,FEV,GCQ)评分均较术前明显升高,且观察组患者肺活量(VC),舒适度评分(GCQ)均较对照组高(P <0. 05);两组患者残气量(RV)均较术前明显下降(P <0. 05)。观察组患者术后拔管时间、住院时间、并发症发生率均明显低于对照组(P <0. 05)。结论循证护理可针对LVRS患者治疗期间存在的问题采取预防措施,减轻患者的身心负担,提升护理质量。
Objective To explore the application effect of evidence-based nursing in the perioperative period of patients with thoracoscopic lung volume reduction surgery( LVRS). Methods A total of 82 cases of patients with emphysema who were treated with thoracoscopic lung volume reduction surgery in our hospital from January 2016 to January 2018 were selected as the study subjects. They were divided into control group and observation group with the same number of patients randomly. The control group was treated with routine nursing for the lung volume reduction surgery,while the observation group was treated with the evidence-based nursing to solve the physical and mental problems that patients with lung volume reduction surgery were prone to have during perioperative period. The lung function index,exercise capacity index and comfort score of the two groups were compared before operation,and at 1 day before discharge. The hospitalization time,extubation time of mechanical ventilation and incidence of postoperative complications were compared between the two groups. Results The scores of lung function indexes( VC,FVC1,FEV and GCQ) of patients in the two groups before discharge were significantly higher than that before the surgery,and the vital capacity( VC) and general comfort questionnaire( GCQ) scores of the observation group were higher than that of the control group( P < 0. 05). The residual volume( RV) of the patients in the two groups were significantly lower than that before the surgery( P < 0. 05). The postoperative extubation time,hospitalization time and incidence of complications in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion Evidence-based nursing can provide preventive measures against the problems existing during the treatment of patients with LVRS. Meanwhile,it can reduce the physical and mental burden of patients and improve the quality of nursing.
Objective To explore the application effect of evidence-based nursing in the perioperative period of patients with thoracoscopic lung volume reduction surgery( LVRS). Methods A total of 82 cases of patients with emphysema who were treated with thoracoscopic lung volume reduction surgery in our hospital from January 2016 to January 2018 were selected as the study subjects. They were divided into control group and observation group with the same number of patients randomly. The control group was treated with routine nursing for the lung volume reduction surgery,while the observation group was treated with the evidence-based nursing to solve the physical and mental problems that patients with lung volume reduction surgery were prone to have during perioperative period. The lung function index,exercise capacity index and comfort score of the two groups were compared before operation,and at 1 day before discharge. The hospitalization time,extubation time of mechanical ventilation and incidence of postoperative complications were compared between the two groups. Results The scores of lung function indexes( VC,FVC1,FEV and GCQ) of patients in the two groups before discharge were significantly higher than that before the surgery,and the vital capacity( VC) and general comfort questionnaire( GCQ) scores of the observation group were higher than that of the control group( P < 0. 05). The residual volume( RV) of the patients in the two groups were significantly lower than that before the surgery( P < 0. 05). The postoperative extubation time,hospitalization time and incidence of complications in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion Evidence-based nursing can provide preventive measures against the problems existing during the treatment of patients with LVRS. Meanwhile,it can reduce the physical and mental burden of patients and improve the quality of nursing.
引文
[1]黄秋婷,陈淑超,林素珠.肺减容术治疗重度肺气肿的围术期综合护理效果分析[J].按摩与康复医学,2018,9(9):78-79.
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[4]苏永超,田作春,曹卫东,等.单侧胸腔镜下肺减容术治疗老年性大疱型肺气肿[J].中国现代医学杂志,2017,27(16):95-98.
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[7]张晓洁,陈志明,张秋实,黄世恩,邓旻.电视胸腔镜下肺减容术对重度慢性阻塞性肺气肿患者炎性因子、肺功能及生活质量的影响[J].中国内镜杂志,2016,22(7):14-17.
[8]唐力娇,刘远英,杨满芳.NEOVEIL管状补片在胸腔镜肺减容术中应用的护理配合[J].护理实践与研究,2016,13(6):109-110.
[9]邹强,赵夏,黄云,等.胸腔镜与常规切口肺减容术治疗重度慢性阻塞性肺气肿患者的对比研究[J].西部医学,2016,28(3):389-392.
[10]刘艳芹.对慢阻肺患者进行循证护理对提高其呼吸训练依从性的效果分析[J].临床医药文献电子杂志,2017,4(99):19490,19492.
[11]白雅仙.肺减容术治疗重度肺气肿的围术期综合护理效果分析[J].临床医药文献电子杂志,2016,3(7):1277-1278.
[12]孙亚妮,贾珊,周小莎,等.支气管镜肺减容术治疗重度肺气肿的的临床护理[J].中华肺部疾病杂志(电子版),2016,9(1):106-107.
[13]程娟.胸腔镜肺减容术治疗重度肺气肿的效果及临床价值分析[J].中国医药指南,2015,13(35):92-93.
[14]黄金穗,吴卫春,孔海红.肺气肿合并气胸行胸腔镜肺减容术围手术期呼吸道的护理[J].中国微创外科杂志,2015,15(5):478-480.
[2]刘守知.胸腔镜下肺减容术治疗重度慢性阻塞性肺气肿的效果分析[J].河南医学研究,2017,26(22):4146-4147.
[3]蒋颖博,吾日也提·吾甫尔,等.人性化护理关怀在肺减容术后患者中的应用[J].中国社区医师,2017,33(31):119-120.
[4]苏永超,田作春,曹卫东,等.单侧胸腔镜下肺减容术治疗老年性大疱型肺气肿[J].中国现代医学杂志,2017,27(16):95-98.
[5]赵维.1例肺减容术后反复出现皮下气肿患者的护理体会[J].中日友好医院学报,2017,31(2):127.
[6]彭建明.胸腔镜下肺减容术在肺气肿治疗中的价值分析[J].中国社区医师,2017,33(4):20-21.
[7]张晓洁,陈志明,张秋实,黄世恩,邓旻.电视胸腔镜下肺减容术对重度慢性阻塞性肺气肿患者炎性因子、肺功能及生活质量的影响[J].中国内镜杂志,2016,22(7):14-17.
[8]唐力娇,刘远英,杨满芳.NEOVEIL管状补片在胸腔镜肺减容术中应用的护理配合[J].护理实践与研究,2016,13(6):109-110.
[9]邹强,赵夏,黄云,等.胸腔镜与常规切口肺减容术治疗重度慢性阻塞性肺气肿患者的对比研究[J].西部医学,2016,28(3):389-392.
[10]刘艳芹.对慢阻肺患者进行循证护理对提高其呼吸训练依从性的效果分析[J].临床医药文献电子杂志,2017,4(99):19490,19492.
[11]白雅仙.肺减容术治疗重度肺气肿的围术期综合护理效果分析[J].临床医药文献电子杂志,2016,3(7):1277-1278.
[12]孙亚妮,贾珊,周小莎,等.支气管镜肺减容术治疗重度肺气肿的的临床护理[J].中华肺部疾病杂志(电子版),2016,9(1):106-107.
[13]程娟.胸腔镜肺减容术治疗重度肺气肿的效果及临床价值分析[J].中国医药指南,2015,13(35):92-93.
[14]黄金穗,吴卫春,孔海红.肺气肿合并气胸行胸腔镜肺减容术围手术期呼吸道的护理[J].中国微创外科杂志,2015,15(5):478-480.