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目的探讨基于微信和定期门诊护理相结合的多元化延续护理干预在经皮内镜下胃/空肠造瘘术(PEG/PEJ)后出院患者中的应用效果。方法入选2013年7月至2015年6月PEG/PEJ患者62例,随机分为常规组(n=30)和实验组(n=32)。常规组仅在出院时给予出院指导并发放指导手册,实验组在出院指导和发放指导手册的基础上利用微信公众号进行家庭健康教育和每周定期门诊护理指导。对比两组出院4周内PEG/PEJ相关并发症发生情况,采用SF-36生活质量量表评估两组患者出院4周时生活质量,采用问卷方式调查患者满意度。结果实验组出院4周内PEG/PEJ相关并发症发生率(9.38%vs 40.00%)显著低于常规组(P<0.01),出院4周时SF-36生活质量评分中生理健康(72.43±19.82 vs 62.11±18.24)、心理健康(63.37±17.29 vs 54.29±16.77)、生理功能(82.17±19.06 vs 70.35±18.44)和社会功能(69.45±20.15 vs 58.80±18.09)总分均显著高于常规组(P均<0.05),患者满意度显著高于常规组(84.38%vs 50.00%,P<0.01)。结论基于微信和定期门诊护理相结合的多元化延续护理干预可以有效降低PEG/PEJ并发症发生率,进而提高患者生活质量和满意度。
Objective To investigate the effect of diversified continuation nursing intervention based on the combination of WeChat and regular outpatient care in discharged patients after percutaneous endoscopic gastro / jejunostomy (PEG / PEJ). Methods Sixty-two patients with PEG / PEJ from July 2013 to June 2015 were randomly divided into routine group (n = 30) and experimental group (n = 32). The regular group was given discharge instruction and discharged the instruction manual only when discharged from the hospital. The experimental group used the WeChat public number to provide family health education and regular weekly outpatient nursing guidance on the basis of discharge guidance and issuance of instruction manual. The incidence of complications related to PEG / PEJ within 4 weeks after discharge was compared between two groups. The quality of life of the two groups was evaluated by SF-36 Quality of Life Scale at 4 weeks after discharge. The patient satisfaction was investigated by questionnaire. Results The incidence of PEG / PEJ-related complications (9.38% vs 40.00%) in the experimental group within 4 weeks after discharge was significantly lower than that in the conventional group (P <0.01). After 4 weeks of discharge, the physiological health in the SF-36 quality of life score was 72.43 ± 19.82 (62.17 ± 18.24 vs 54.29 ± 16.77), and the total score of physiological function (82.17 ± 19.06 vs 70.35 ± 18.44) and social function (69.45 ± 20.15 vs 58.80 ± 18.09) were significantly higher than those in the conventional group P <0.05). The patients’ satisfaction was significantly higher than that of the control group (84.38% vs 50.00%, P <0.01). Conclusion The diversified continuation nursing intervention based on WeChat and regular outpatient care can effectively reduce the incidence of complications of PEG / PEJ, thereby improving the quality of life and satisfaction of patients.