移動宣教平臺在行外科手術的血液透析患者中的應用效果

劉蘭霞　張建榮　陳志錦

[摘要]目的 探討移動宣教平臺在行外科手術的血液透析患者中的應用效果。方法 選取2016年1月～2017年12月我院收治且行手術的透析患者107例。采用目的抽樣法，將2016年1～12月收治且行手術的透析患者53例設為對照組，將2017年1～12月收治且行手術的透析患者54例設為觀察組。觀察組圍術期采用血透專科護士基于微信平臺構建的移動、便捷、可視宣教模式，對照組圍術期采用常規外科護士面對面健康宣教模式，比較兩組患者術前對預防手術部位感染認知情況、術后切口愈合情況、手術部位感染發生率。結果 觀察組術前預防手術部位感染認知情況、術后切口愈合情況均優于對照組，差異有統計學意義（P<0.05），手術部位感染發生率低于對照組，差異有統計學意義（P<0.05）。結論 血透專科護士指導下的移動宣教平臺能夠對行外科手術的透析患者進行更為便捷有效的指導，提高患者預防手術部位感染認知，降低手術部位感染發生率。

[關鍵詞]血液透析；移動宣教平臺；外科；手術；感染

[中圖分類號] R473.5 [文獻標識碼] A [文章編號] 1674-4721（2018）6（c）-0164-03

[Abstract]Objective To explore the application effect of mobile propaganda and education platform in hemodialysis patients performed with surgeries.Methods A total of 107 dialysis patients admitted to our hospital from January 2016 to December 2017 who underwent surgery were selected.Using objective sampling method，53 patients admitted from January to December 2016 were set as control group and 54 patients admitted from January to December 2017 were set as observation group.The observation group adopted a mobile，convenient and visual education model built by hemodialysis specialist nurses based on wechat platform during the perioperative period，while the control group adopted a face-to-face health education model for routine surgical nurses during the perioperative period.The preoperative awareness of the prevention of surgical site infection， postoperative wound healing， and the incidence of surgical site infection in the two groups were compared.Results The observation group was better than the control group in the cognition of prevention of surgical site infection before operation and the healing of incision after operation，and the difference was statistically significant （P<0.05）. The incidence of surgical site infection in the observation was lower than that of the control group， and the difference was statistically significant （P<0.05）.Conclusion The mobile propaganda and education platform under the guidance of professional nurses in the hemodialysis room can provide convenient and effective guidance for hemodialysis patients undergoing surgeries.It can improve patients′ knowledge of infection prevention in surgical sites and reduce the incidence of surgical site infection.

[Key words]Hemodialysis；Mobile propaganda and education platform；Department of Surgery；Operation；Infection

目前我國血液透析患者數量呈現逐年增長趨勢[1-2]，行外科手術的血液透析患者數量也呈現增長趨勢[3]；而行手術的血液透析患者與其他手術患者相比，更容易出現貧血、低蛋白血癥、電解質紊亂等，這些因素使得血液透析患者手術部位感染發生率往往高于其他患者[4-5]。外科的醫護由于不夠專業，對透析期間行手術患者的宣教內容只關注本專業，而忽略強調與血液透析相關的圍術期宣教。2017年1月開始我院在血液透析專科護士指導下，基于微信平臺構建了移動、便捷、可視性宣教模式，對行外科手術的血液透析患者進行預防手術部位感染的相關知識宣教，以期降低手術部位感染發生率，現取得良好效果，現報道如下。