循證護(hù)理模式在肝脾破裂手術(shù)中的應(yīng)用效果

李彩霞 劉鴻凱

[摘要]目的 分析在肝脾破裂手術(shù)后進(jìn)行循證護(hù)理模式的具體效果和實(shí)際價(jià)值。方法 選取我院2014年12月～2017年12月收治的肝脾破裂手術(shù)患者78例，根據(jù)入院先后順序?qū)⑵渚譃閮山M，每組各39例。對照組使用常規(guī)護(hù)理模式，觀察組使用循證護(hù)理模式。比較兩組生活質(zhì)量評分（ADL）、疼痛評分（VAS）、住院時(shí)間、并發(fā)癥發(fā)生率、護(hù)理滿意度和總有效率。結(jié)果 兩組護(hù)理后ADL評分和VAS評分高于護(hù)理前，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；兩組護(hù)理前ADL評分和VAS評分比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）；觀察組護(hù)理后ADL評分、VAS評分和住院時(shí)間明顯高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組并發(fā)癥發(fā)生率為7.69%，低于對照組（23.08%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組護(hù)理滿意度為94.88%，高于對照組（79.48%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組總有效率為97.44%，高于對照組（82.06%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 對肝脾破裂手術(shù)患者使用循證護(hù)理模式能有效縮短患者住院時(shí)間，提高生活質(zhì)量，減少患者疼痛感和并發(fā)癥發(fā)生率，患者反映普遍較好，且整體護(hù)理效果明顯，可在各大醫(yī)院中推廣使用。

[關(guān)鍵詞]肝脾破裂手術(shù)；循證護(hù)理模式；效果觀察

[中圖分類號] R473.6 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-4721（2018）5（c）-0185-04

Application of effect of evidence-based nursing mode in liver and spleen rupture surgery

LI Cai-xia LIU Hong-kai

Department of Surgery，Maonan District People′s Hospital of Maoming City，Guangdong Province，Maoming 525011，China

[Abstract]Objective To analyze the specific effect and practical value of evidence-based nursing mode after liver and spleen rupture surgery.Methods Altogether 78 patients who underwent liver and spleen rupture surgery in our hospital from December 2014 to December 2017 were selected and divided into control group and observation group according to the order of admission，39 cases in each group.The control group was treated with conventional nursing mode，while the observation group was treated with evidence-based nursing mode.The activities of daily life （ADL） quality of life score，visual analogue scale（VAS） pain score，length of stay，complication rate，nursing satisfaction and total effective rate were compared between the two groups.Results The post-nursing ADL quality of life score and VAS pain score of the observation group and the control group were higher than those before the nursing，with statistically significant difference （P<0.05）.There was no statistically significant difference between the two groups in pre-nursing ADL quality of life score and VAS pain score （P>0.05）.The post-nursing ADL quality of life score，VAS pain score and length of stay of the observation group were significantly higher than those of control group，with statistically significant difference （P<0.05）.The incidence of complications of the observation group was 7.69%，lower than that of the control group （23.08%），with statistically significant difference （P<0.05）.The nursing satisfaction of the observation group was 94.88%，higher than that of the control group （79.48%），with statistically significant difference （P<0.05）.The total effective rate of the observation group was 97.44%，higher than that of the control group （82.06%），with statistically significant difference （P<0.05）.Conclusion Application of evidence-based nursing model for patients with liver and spleen rupture can effectively shorten the patients′ hospitalization time，improve the quality of life and reduce the pain perception and complication rate，with generally good patients′ reflection and obvious overall nursing effect，which can be popularized in the major hospitals.

[Key words]Liver and spleen rupture surgery；Evidence-based nursing mode；Effect observation

隨著社會發(fā)展不斷進(jìn)步，車禍、高空墜物等損傷事件頻繁出現(xiàn)，而人體脾臟本身是一個(gè)供血豐富的脆弱器官組織，故而在經(jīng)受強(qiáng)烈撞擊后，易出現(xiàn)創(chuàng)傷性脾臟出血[1]。肝脾破裂患者大都是閉合性損傷，發(fā)病迅速以及病情進(jìn)展較快是兩個(gè)較為明顯的特點(diǎn)。臨床上對肝脾破裂患者最常用的治療方法是行肝脾破裂修補(bǔ)術(shù)，在肝脾破裂患者圍術(shù)期間行護(hù)理可有效提高治療效果[2]。本研究在肝脾破裂患者圍術(shù)期間行循證護(hù)理模式，取得較好成果，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料

選取2014年12月～2017年12月在我院接受護(hù)理肝脾破裂手術(shù)患者78例為研究對象，根據(jù)入院先后順序?qū)⑵渚譃閷φ战M和觀察組，每組各39例。對照組男20例，女19例；年齡41～65歲，平均（53.2±5.7）歲。觀察組男22例，女17例；年齡40～66歲，平均（53.3±5.5）歲。兩組的一般資料比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。……