楊文娟 韓小寒
【摘要】目的:分析手術(shù)室護(hù)理干預(yù)在良性卵巢囊腫腹腔鏡微創(chuàng)手術(shù)中的應(yīng)用效果。方法:選取我院2020年12月—2021年9月良性卵巢囊腫患者83例,護(hù)理模式分組,A組(手術(shù)室護(hù)理干預(yù))41例,B組(常規(guī)護(hù)理)42例,比較兩組患者恢復(fù)效率、睡眠質(zhì)量、滿意度。結(jié)果:恢復(fù)效率比較,A組下床活動(dòng)較早,患者術(shù)后較早排氣,住院時(shí)間較短(P<0.05);睡眠質(zhì)量比較,A組[(6.65±1.23)分]優(yōu)于B組[(10.59±1.42)分](P<0.05);滿意度比較,A組[100.00%(41/41)]優(yōu)于B組[80.95%(34/42)](P<0.05)。結(jié)論:在針對良性卵巢囊腫患者進(jìn)行腹腔鏡微創(chuàng)手術(shù)時(shí),手術(shù)室護(hù)理干預(yù)具有顯著的應(yīng)用價(jià)值,可提高恢復(fù)效率,改善睡眠質(zhì)量,提高滿意度。
【關(guān)鍵詞】手術(shù)室護(hù)理干預(yù);腹腔鏡微創(chuàng)手術(shù);良性卵巢囊腫;滿意度
To explore the effect of operation room nursing intervention in laparoscopic minimally invasive surgery for benign ovarian cyst
YANG Wenjuan, HAN Xiaohan
Maternal and Child Health Hospital of Anhui Province, Hefei, Anhui 230088, China
【Abstract】Objective: To analyze the effect of operation room nursing intervention in laparoscopic minimally invasive surgery for benign ovarian cyst.Methods: From December 2020 to September 2021, 83 patients with benign ovarian cyst in our hospital were selected, and the nursing mode was divided into group A (operating room nursing intervention) 41 cases, group B (routine nursing) 42 cases, and the recovery efficiency, sleep quality and satisfaction of the two groups were compared. Results: Compared with recovery efficiency, group A had earlier movement out of bed, earlier postoperative exhaust and shorter hospital stay(P<0.05). The sleep quality of group A [(6.65±1.23) points] was better than that of group B [(10.59±1.42) points](P<0.05).The satisfaction of group A [100.00% (41/41)] was better than that of group B [80.95% (34/42)] (P<0.05).Conclusion: For benign ovarian cyst patients undergoing laparoscopic minimally invasive surgery, operating room nursing intervention has significant application value, can improve recovery efficiency, improve sleep quality, improve satisfaction.
【Key Words】Operating room nursing intervention; Laparoscopic minimally invasive surgery; Benign ovarian cyst; Satisfaction
卵巢囊腫屬于婦科常見疾病[1]。腹腔鏡微創(chuàng)手術(shù)在卵巢囊腫治療中應(yīng)用療效較好,該手術(shù)對機(jī)體創(chuàng)傷較小[2]。但是因?yàn)槭中g(shù)部位特殊性,以及許多患者對手術(shù)療效和預(yù)后存在顧慮,常見負(fù)性情緒與睡眠質(zhì)量降低等表現(xiàn)[3]。常規(guī)護(hù)理臨床效果低于預(yù)期,手術(shù)室護(hù)理干預(yù)是圍繞手術(shù)需求構(gòu)建的護(hù)理模式,護(hù)理措施更積極,干預(yù)強(qiáng)度更高[4]。本文從我院2020年12月—2021年9月實(shí)施腹腔鏡微創(chuàng)手術(shù)治療的患者中選取83例良性卵巢囊腫患者,說明手術(shù)室護(hù)理干預(yù),觀察應(yīng)用效果。
1.1 一般資料
選取2020年12月—2021年9月我院83例良性卵巢囊腫患者,按照護(hù)理模式分為,A組41例,年齡22~51歲,平均年齡(32.69±6.47)歲,腫瘤直徑5~13cm,平均直徑(6.45±1.30)cm,其中單側(cè)囊腫26例,雙側(cè)囊腫15例;B組42例,年齡23~50歲,平均年齡(32.71±6.45)歲,腫瘤直徑6~13cm,平均直徑(6.47±1.28)cm,單側(cè)囊腫25例,雙側(cè)囊腫17例。資料可予分析(P>0.05)。納入標(biāo)準(zhǔn):①良性卵巢囊腫確診;②符合腹腔鏡微創(chuàng)手術(shù)指征;③自主意識良好;④溝通能力正常;⑤患者知情同意。排除標(biāo)準(zhǔn):①凝血功能異常;②免疫系統(tǒng)異常;③精神障礙;④智力異常;⑤資料不全。
1.2 方法
全部患者實(shí)施腹腔鏡微創(chuàng)手術(shù)治療。B組行常規(guī)護(hù)理:術(shù)前訪視與常規(guī)宣教,術(shù)中輔助醫(yī)師進(jìn)行患者情況監(jiān)測,術(shù)后進(jìn)行恢復(fù)管理和預(yù)防并發(fā)癥。
A組行手術(shù)室護(hù)理干預(yù):(1)術(shù)前1d訪視,綜合評估患者情況,重點(diǎn)進(jìn)行心理干預(yù)和睡眠管理,促進(jìn)患者保持良好身心狀態(tài),積極面對手術(shù)。簡要說明麻醉與手術(shù)方法,進(jìn)行個(gè)性化宣教,緩解患者負(fù)性情緒。(2)術(shù)前規(guī)范準(zhǔn)備手術(shù)備品,檢查和調(diào)試器械。(3)幫助患者熟悉手術(shù)室環(huán)境,預(yù)防環(huán)境應(yīng)激影響。麻醉護(hù)理中監(jiān)測血壓等生命體征,控制輸液速度。(4)術(shù)中規(guī)范核對器械,及時(shí)清理器械,配合醫(yī)師實(shí)施手術(shù)操作??茖W(xué)調(diào)節(jié)患者體位,實(shí)施動(dòng)態(tài)監(jiān)護(hù),預(yù)防電流灼傷。(5)調(diào)節(jié)光源強(qiáng)度與氣腹機(jī)參數(shù),嚴(yán)密監(jiān)測體征,科學(xué)補(bǔ)液和控制輸液速度。(6)手術(shù)完成后,等待患者蘇醒,護(hù)送患者回到病房。
1.3 觀察指標(biāo)
恢復(fù)效率:統(tǒng)計(jì)患者術(shù)后肛門排氣、下床活動(dòng)、住院時(shí)間。
睡眠質(zhì)量:《匹茲堡睡眠質(zhì)量指數(shù)分析量表》(即PSQI)在護(hù)理前后分別評價(jià)患者睡眠情況。共24項(xiàng),總分0~21分,分為入睡效率、睡眠時(shí)間、入睡時(shí)間、睡眠質(zhì)量、助眠用藥、日間功能7個(gè)方面,PSQI評分超過7分為睡眠障礙,PSQI分?jǐn)?shù)與睡眠質(zhì)量呈負(fù)相關(guān)。
滿意度:管理組自制調(diào)查問卷,患者填寫,回收統(tǒng)計(jì)評分。(1)評分>90分,優(yōu);(2)81~90分,良;(3)71~80分,中;(4)0~70分,差。滿意度=[(1)+(2)]÷(本組n)×100.00%。
1.4 統(tǒng)計(jì)學(xué)方法
采用SPSS 24.0統(tǒng)計(jì)學(xué)軟件進(jìn)行數(shù)據(jù)分析。計(jì)數(shù)資料采用(%)表示,進(jìn)行χ2檢驗(yàn),計(jì)量資料采用(χ±s) 表示,進(jìn)行t檢驗(yàn),P<0.05為差異具有統(tǒng)計(jì)學(xué)意義。
2.1 恢復(fù)效率
A組下床活動(dòng)時(shí)間、肛門排氣時(shí)間以及出院時(shí)間較早,B組較長(P<0.05),見表1。
2.2 睡眠質(zhì)量
干預(yù)前,組間PSQI評分差異無統(tǒng)計(jì)學(xué)意義(P>0.05);干預(yù)后,A組PSQI評分
2.3 滿意度
A組滿意度(%)>B組(%)(P<0.05),A組差評率(%)