胃結腸息肉患者應用內鏡下切除的術后護理體會

徐玲燕+李莉+吳白慧

[摘要] 目的 總結對胃結腸息肉患者提供內鏡切除術治療的術后護理要點。 方法 將我院于2013年5月～2015年3月間收治的92例胃結腸息肉患者，按照隨機數字表法將患者劃分為對照組46例與研究組46例，為對照組患者提供常規圍手術期護理服務，為研究組患者提供術后護理干預，總結兩組患者術后穿孔及出血發生率，評估患者對護理質量評分及心理焦慮評分。 結果 對照組患者術后出血、1年后息肉復發率均高于研究組（P<0.05），但穿孔發生率結果組間比較差異無統計學意義（P>0.05）。對照組患者對于臨床提供的術后并發癥預防、健康教育、飲食指導及用藥監督等服務質量評分均低于研究組（P<0.05）。干預前兩組患者心理焦慮評分結果比較差異無統計學意義（P>0.05）；干預后，研究組患者心理焦慮評分低于對照組（P<0.05）。 結論 護士為胃結腸息肉患者提供常規護理基礎上，重點做好術后護理干預措施，可有效降低術后并發癥發生率，改善患者心理焦慮情緒，提高科室護理質量。

[關鍵詞] 胃結腸息肉；內鏡；切除手術；護理干預

[中圖分類號] R473.73 [文獻標識碼] B [文章編號] 1673-9701（2017）15-0147-04

[Abstract] Objective To summarize the postoperative nursing points of endoscopic resection of gastric colorectal polyps patients. Methods 92 patients with gastric colonic polyps admitted in our hospital from May 2013 to March 2015 were divided into control group（n=46） and study group（n=46） according to the random number table. The nurses provided routine perioperative care for the control group and provided postoperative care intervention for the study group. The incidences of postoperative perforation and hemorrhage in both groups were summarized， and the scores of nursing quality and psychological anxiety were evaluated. Results The postoperative puncture， hemorrhage， polyp recurrence rate after one year in the control group were higher than those in the study group（P<0.05）. But the incidence of perforation was not statistically significant between the two groups（P>0.05）. The service quality scores of the postoperative complications prevention， health education， diet guidance and medication supervision in the control group were lower than those in the study group（P<0.05）. There was no significant difference in the scores of psychological anxiety between the two groups before the intervention， P>0.05. After intervention， the psychological anxiety score of the study group was lower than that of the control group（P<0.05）. Conclusion Focusing on postoperative nursing intervention based on the routine nursing provided by nurses for patients with gastric colonic polyps can effectively reduce the incidence of postoperative complications， and improve the psychological anxiety and the quality of nursing.

[Key words] Gastrointestinal polyp； Endoscopy； Resection surgery； Nursing intervention

胃結腸息肉疾病屬于消化道常見疾病，是指發生在胃部及腸道黏膜的良性增生組織，發病率較高，且多無自覺癥狀，一般由胃鏡及其他檢查過程中偶然發現，目前臨床尚未明確此種疾病病因，發展至后期部分患者可能出現血便、黑便、腹痛等[1，2]。針對此種疾病多采用手術治療為主，隨著現代臨床醫療技術不斷發展，微創內鏡手術在臨床應用范圍較廣，本次研究中為此類患者提供內鏡下高頻電凝切除術治療，此種手術相較于傳統開腹手術，主要優勢包括微創、出血量少，但術后存在并發癥，常見并發癥類型包括出血、穿孔，為了有效降低術后并發癥發生率[3]，本文總結對胃結腸息肉患者提供內鏡切除術治療的術后護理要點，現報道如下。……