切换至 "中华医学电子期刊资源库"
高级检索
中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (04) : 463 -467. doi: 10.3877/cma.j.issn.1674-392X.2022.04.022

临床论著

术前访视联合循证护理对改善腹股沟疝修补术患者应激状态的影响
张申洪1, 张代英1, 邓文雪1, 黄荣惠1, 张云磊1, 梁瑞晨1,†()   
  1. 1. 646000　四川泸州，西南医科大学附属医院手术室
  • 收稿日期:2021-12-23 出版日期:2022-08-18
  • 通信作者: 梁瑞晨
  • 基金资助:
    西南医科大学校级科研项目(2017-ZRQN-049)

Effect of preoperative visit combined with evidence-based nursing on improving stress state of patients undergoing inguinal hernia repair

Shenhong Zhang1, Daiying Zhang1, Wenxue Deng1, Ronghui Huang1, Yunlei Zhang1, Ruichen Liang1,†()   

  1. 1. Operating Room, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • Received:2021-12-23 Published:2022-08-18
  • Corresponding author: Ruichen Liang
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

张申洪, 张代英, 邓文雪, 黄荣惠, 张云磊, 梁瑞晨. 术前访视联合循证护理对改善腹股沟疝修补术患者应激状态的影响[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(04): 463-467.

Shenhong Zhang, Daiying Zhang, Wenxue Deng, Ronghui Huang, Yunlei Zhang, Ruichen Liang. Effect of preoperative visit combined with evidence-based nursing on improving stress state of patients undergoing inguinal hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(04): 463-467.

目的

探讨术前访视联合循证护理对改善腹股沟疝修补术患者应激状态的影响。

方法

选取2020年6月至2021年8月西南医科大学附属医院收治的104例患者作为研究对象，根据护理方法不同分为2组，每组患者52例。对照组患者进行常规护理干预，干预组患者进行术前访视联合循证护理干预。对比分析2组患者干预后视觉模拟评分法（VAS）、术后恢复情况、心理状态、并发症发生情况及满意度。

结果

2组患者在术前VAS评分比较，差异无统计学意义（P>0.05）；干预组在术后12、24、48 h VAS评分均显著低于对照组，差异有统计学意义（P<0.05）。干预组下床活动时间、开始进食时间、术后肛门排气时间、肠鸣音恢复时间、住院天数均显著低于对照组，差异均有统计学意义（P<0.05）。2组患者干预前SDS和SAS评分比较，差异无统计学意义（P>0.05）；并且干预后所有患者SDS评分和SAS评分均明显下降，且干预组SDS评分和SAS评分均显著低于对照组，差异有统计学意义（P<0.05）。干预组患者总并发症率低于对照组，差异有统计学意义（P<0.05）。干预组护理满意度显著高于对照组，差异有统计学意义（P<0.05）。

结论

术前访视联合循证护理可有效减轻腹股沟患者疼痛，提高康复质量，加速患者康复，缓解患者心理状况和应激状态，提高患者满意度。

关键词: 疝，腹股沟, 循证护理, 疝修补术, 应激状态, 疼痛
Objective

To investigate the effect of preoperative visit combined with evidence-based nursing on improving the stress state of patients undergoing inguinal hernia repair.

Methods

104 patients admitted to the Affiliated Hospital of Southwest Medical University from June 2020 to August 2021 were selected as the research subjects. Patients were divided into two groups according to different nursing methods, with 52 patients in each group. The control group received routine nursing intervention, and the intervention group received preoperative visit combined with evidence-based nursing interventions. The visual analogue scale (VAS) score, postoperative recovery, psychological state, complications and satisfaction were compared between the two groups after intervention.

Results

There was no significant difference in VAS scores between the two groups before the intervention (P>0.05). The VAS scores of the intervention group were significantly lower than those of the control group at 12, 24, and 48 hours after the intervention (P<0.05). The times of getting out of bed, starting to eat, postoperative anal exhaust, bowel sound recovery, and the length of hospital stay in the intervention group was significantly lower than those in the control group (P<0.05). There was no significant difference in SDS and SAS scores between the two groups before the intervention (P>0.05). After intervention, the SDS and SAS scores of all patients were significantly decreased, and the SDS and SAS scores of the intervention group were significantly lower than those of the control group (P<0.05). The incidence of postoperative complications in the intervention group was significantly lower than that of the control group, the difference was statistically significant (P<0.05). The nursing satisfaction of intervention group was significantly higher than that of control group, and the difference was statistically significant (P<0.05).

Conclusion

Preoperative visit combined with evidence-based nursing can effectively relieve pain in patients with inguinal hernia, improve the quality of rehabilitation, accelerate patients' recovery, relieve patients' psychological and stress state, and improve patients’ satisfaction.

Key words: Hernia, inguinal, Evidence-based nursing, Herniorrhaphy, Stress state, Pain
表1 2组患者术后视觉模拟评分比较（分，±s）
组别 例数 术前 术后12 h 术后24 h 术后48 h
干预组 52 0.21±1.46 4.88±0.78 3.60±1.21 1.04±0.85
对照组 52 0.23±1.08 5.69±1.08 4.54±1.05 2.06±0.84
t值   1.509 9.797 4.231 6.155
P值   0.134 <0.01 <0.01 <0.01
表2 2组患者术后恢复情况比较（±s）
组别 例数 下床活动时间(h) 开始进食时间(h) 术后肛门排气时间(h) 肠鸣音恢复时间(h) 住院天数(d)
干预组 52 9.98±2.81 7.04±1.33 4.92±2.46 1.19±0.81 4.85±1.77
对照组 52 12.54±1.88 9.88±1.86 6.69±1.69 2.06±0.86 5.69±2.26
t值   5.460 8.956 4.277 5.310 2.110
P值   <0.01 <0.01 <0.01 <0.01 0.037
表3 2组患者手术前后SDS和SAS评分比较（分，±s）
 组别 例数 SDS评分 SAS评分
术前 术后1周 术前 术后1周
干预组 52 59.58±6.42 30.50±6.04* 55.15±4.04 30.46±5.71*
对照组 52 59.54±6.29 40.79±6.02* 54.96±3.68 40.35±5.26*
t值   0.032 8.701 0.251 9.186
P值   0.975 <0.01 0.803 <0.01
表4 2组患者术后并发症发生情况比较
组别 例数 尿潴留(例) 阴囊水肿(例) 伤口红肿(例) 呕心呕吐(例) 便秘(例) 总并发症情况[例(%)]
干预组 52 0 0 1 1 1 3(5.77)a
对照组 52 1 1 1 2 2 7(13.46)
表5 2组患者护理满意度比较
组别 例数 非常满意(例) 一般满意(例) 不满意(例) 护理满意度[例(%)]
干预组 52 33 18 1 51(98.08)a
对照组 52 24 19 9 43(82.69)
[1]
Stephanie CJ, Mathieu A, Aurore M, et, al. Outpatients' perception of their preoperative information regarding their health literacy skills and their preoperative anxiety level: protocol for a prospective multicenter cross-sectional study[J]. Medicine(Baltimore), 2021, 100(20): e26018.
[2]
Liu S, Lu X, Jiang M, et al. Preoperative assessment clinics and case cancellations: a prospective study from a large medical center in China[J]. Ann Transl Med, 2021, 9(19): 1501.
[3]
王兆锦，林志娟，倪庆. 加速康复外科理念在腹股沟疝无张力修补术的应用效果[J]. 中国性科学, 2020, 29(7): 25-29.
[4]
巩晓红. 循证护理模式对卵巢囊肿手术患者焦虑抑郁情绪及术后康复效果的影响[J]. 中国药物与临床, 2020, 20(2): 307-308.
[5]
李亮. 实用腹股沟疝外科学[M]. 西安: 世界图书出版西安有限公司, 2014: 121-123.
[6]
严广斌. 视觉模拟评分法[J/OL]. 中华关节外科杂志(电子版), 2014, 8(2): 273.
[7]
胡海斌. 补中益气汤辅助无张力疝气修补术治疗腹股沟疝患者的临床观察[J]. 中国民间疗法, 2020, 28(7): 51-53.
[8]
马先，贺杰，马俊帅. 丹红注射液结合抗菌药物对腹股沟疝术后血清MMP-2、MMP-9、TIMP-2、TIMP-1及应激指标作用机制研究[J]. 世界中医药, 2019, 14(9): 2404-2407.
[9]
Greenberg JA, Zwiep TM, Sadek J, et al. Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking[J]. Can J Surg, 2021, 64(5): E491-E509.
[10]
朱晓兰，汤松琴. 术前访视中应用AIDET沟通模式对改善腹股沟疝修补术术前应激状态的效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(5): 568-571.
[11]
方忠荣，谢健，黄楚忠. TEP与Millikan治疗对腹股沟疝患者炎性应激状态及预后的影响[J/OL]. 现代医学与健康研究电子杂志, 2020, 4(15): 29-31.
[12]
胡毅平，孙丽丽，陈红, 等. 精细化护理对腹股沟疝修补术患儿及其父母心理压力和社会支持的影响[J]. 中国医药导报, 2020, 17(10): 185-188.
[13]
Rajput SK, Tiwari T, Chaudhary AK. Effect of preoperative multimedia based video information on perioperative anxiety and hemodynamic stability in patients undergoing surgery under spinal anesthesia[J]. J Family Med Prim Care, 2021, 10(1): 237-242.
[14]
杨璐，卞伶玲，杨雨佳. 补偿差异化需求供给法在老年腹股沟疝修补术患者中的应用分析[J]. 河北医药, 2021, 43(16): 2518-2520, 2525.
[15]
陆丽君，许爱兰. 围术期心境感知护理对老年男性腹股沟疝患者无张力修补术后症状自评和应激状态的影响[J]. 国际护理学杂志, 2020, 39(24): 4491-4494.
[16]
阙静，黄艳，李华. 循证护理干预联合个性化健康教育对急性胰腺炎患者应激心理及自我管理能力的影响[J]. 中国医药导报, 2020, 17(22): 181-184.
[17]
孙叶飞，陈晓晨. 腹腔镜下腹股沟嵌顿疝修补术全程护理干预效果[J]. 中国医科大学学报, 2020, 49(1): 84-87.
[18]
喻赛芬. 术前风险评估及对症护理对老年复杂腹股沟疝患者手术安全性的影响及预后恢复情况分析[J]. 医学临床研究, 2020, 37(6): 892-894.
[19]
赵春莲. 循证医学指导下的护理干预对腹股沟疝患者术后康复的影响[J]. 黑龙江科学, 2021, 12(6): 80-81.
[1] 刘嘉嘉, 王承华, 陈绪娇, 刘瑗玲, 王善钰, 屈海花, 张莉. 经阴道子宫-输卵管实时三维超声造影中患者疼痛发生情况及其影响因素分析[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 959-965.
[2] 董红华, 郭艮春, 江磊, 吴雪飞, 马飞翔, 李海凤. 骨科康复一体化模式在踝关节骨折快速康复中的应用[J]. 中华关节外科杂志(电子版), 2023, 17(06): 802-807.
[3] 吴畏, 吴永哲, 李宗倍, 崔宏力, 李华志, 许臣. 轻质大网孔补片腹腔镜下疝修补术治疗老年腹股沟疝的疗效及炎症因子的影响[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 70-73.
[4] 孟飞龙, 华帅, 张莹, 路广海. 经脐单孔腹腔镜后鞘后入路在全腹膜外腹股沟疝修补术中的应用[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 658-660.
[5] 田文, 杨晓冬. 腹腔镜腹股沟疝修补术式选择及注意事项[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 595-597.
[6] 李涛, 陈纲, 李世拥. 腹腔镜下右侧腹股沟斜疝修补术（TAPP）[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 598-598.
[7] 刘跃刚, 薛振峰. 腹腔镜腹股沟疝日间手术在老年患者中的安全性分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 711-714.
[8] 杨瑞洲, 李国栋, 吴向阳. 腹股沟疝术后感染的治疗方法探讨[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 715-719.
[9] 徐金林, 陈征. 抗菌药物临床应用监测对腹股沟疝修补术预防用药及感染的影响[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 720-723.
[10] 于智慧, 赵建军. 后路腰方肌阻滞复合全身麻醉在腹股沟斜疝经腹腹膜前手术中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 734-739.
[11] 田静, 方秀春. 超声引导下横筋膜平面阻滞在儿童腹股沟疝手术的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 740-744.
[12] 李静如, 王江玲, 吴向阳. 简易负压引流在腹股沟疝术后浅部感染中的疗效分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 745-749.
[13] 王红艳, 马艳丽, 郑洁灿. 手术室综合护理在腹股沟疝手术中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 755-758.
[14] 代格格, 杨丽, 胡媛媛, 周文婷. 手术室综合干预在老年腹股沟疝患者中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 759-763.
[15] 王敏, 蒋家斌, 李茂新. 预警宣教联合个性化疼痛管理对腹股沟疝手术患者的影响[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 764-767.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号