标题：预见性护理对恶性梗阻性黄疸ERCP术后恢复及并发症的影响

      作者：王小芳 1，田亚娟 2    铜川市人民医院消化内科 1、内镜室 2，陕西 铜川 727000

      卷次： 2019年30卷17期

      【摘要】 目的 研究预见性护理对恶性梗阻性黄疸经内镜逆行胰胆管造影(ERCP)术后恢复及并发症的影响，为患者的恢复提供临床指导。方法 选取2017年1月至2018年12月期间铜川市人民医院消化内科收治的80例恶性梗阻性黄疸患者作为研究对象，按照随机数表法将其随机分为观察组和对照组，每组40例。两组均进行常规检查与治疗。对照组患者采用常规的护理模式实施干预，观察组患者在此基础上采用预见性护理模式实施干预。出院时，比较两组患者的生活质量评分[采用生活质量量表(QLQ-C30)评价]、并发症发生率、住院时间以及术后恢复满意度。结果 出院时，观察组患者的术后恢复总满意度为95.0%，明显高于对照组的80.0%，差异具有统计学意义(P<0.05)；出院时，QLQ-C30评定结果显示，观察组患者的社会功能、躯体功能、情绪功能、认知功能、角色功能等测评得分分别为(60.3±16.4)分、(58.2±15.7)分、(88.2±13.7)分、(81.6±15.4)分、(61.6±18.3)分，均明显高于对照组的(53.2±15.6)分、(51.6±14.1)分、(81.7±14.2)分、(73.2±14.9)分、(52.5±17.9)分，而疼痛和疲乏得分分别为(31.6±13.6)分、(43.2±14.6)分，均明显低于对照组的(38.4±14.1)分、(49.3±15.1)分，差异均具有统计学意义(P<0.05)；出院时，观察组患者术后并发症发生率为5.0%，明显低于对照组的20.0%，差异具有统计学意义(P<0.05)；观察组患者的平均住院时间为(9.27±1.52) d，明显低于对照组的(14.64±1.69) d，差异具有统计学意义(P<0.05)。结论 预见性护理模式对恶性梗阻性黄疸患者实施干预，可以有效降低患者并发症的发生率，改善患者生活质量，提高患者的满意度，具有临床应用价值。
      【关键词】 梗阻性黄疸；预见性护理；并发症；生活质量；术后恢复；满意度
      【中图分类号】 R473.5 【文献标识码】 A 【文章编号】 1003—6350（2019）17—2310—03

Effect of predictive nursing on recovery and complications after ERCP for malignant obstructive jaundice.
WANGXiao-fang 1, TIAN Ya-juan 2. Department of Gastroenterology 1, Endoscopy Room 2, the People's Hospital of Tongchuan City,Tongchuan 727000, Shaanxi, CHINA
【Abstract】 Objective To study the effect of predictive nursing on the recovery and complications of malignantobstructive jaundice after endoscopic retrograde cholangiopancreatography (ERCP), and to provide clinical guidance forthe recovery of patients. Methods Eighty patients with malignant obstructive jaundice received by Department of Gas-troenterology of Tongchuan People's Hospital from January 2017 to December 2018 were selected as the study subjects.According to random number table method, the patients were divided into the observation group and control group, with40 cases in each group. Routine examination and treatment were carried out in both groups. The patients in the controlgroup were intervened by routine nursing mode, while the patients in the observation group were intervened by predic-tive nursing mode. When discharged from hospital, the quality of life score (QLQ-C30), incidence of complications, hos-pitalization time and satisfaction with recovery after operation were compared between the two groups. Results On dis-charge, the total satisfaction rate of the patients in the observation group was 95.0%, which was significantly higher than80.0% in the control group (P<0.05); the scores of social function, physical function, emotional function, cognitive func-tion and role function of the patients in the observation group were 60.3±16.4, 58.2±15.7, 88.2±13.7, 81.6±15.4, 61.6±18.3, respectively, which were significantly higher than corresponding 53.2 ± 15.6, 51.6 ± 14.1, 81.7 ± 14.2, 73.2 ± 14.9,52.5±17.9 of the patients in the control group (all P<0.05); while, the scores of pain and fatigue in the observation groupwere 31.6 ±13.6 and 43.2±14.6 respectively, which were significantly lower than 38.4±14.1 and 49.3±15.1 in the controlgroup (all P<0.05); the incidence of postoperative complications in the observation group was 5.0%, which was signifi-cantly lower than 20.0% in the control group (P<0.05); the average hospitalization time in the observation group was(9.27±1.52) days, which was significantly lower than (14.64±1.69) days in the control group (P<0.05). Conclusion Theintervention of predictive nursing model for malignant obstructive jaundice patients can effectively reduce the incidenceof complications, improve the quality of life of patients and patient satisfaction. It has clinical application value.
      【Key words】 Obstructive jaundice; Predictive nursing; Complications; Quality of life; Postoperative recovery;Satisfaction·护理·doi:10.3969/j.issn.1003-6350.2019.17.042