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目的探讨循证护理在膀胱癌全切回肠代膀胱腹壁造瘘围术期实施的护理效果。方法选取48例接受膀胱全切回肠代膀胱腹壁造瘘术治疗的膀胱癌患者作为研究对象,在患者知情同意并签署知情同意术下,采用单双数字分组法将其分为观察组和对照组(各24例);对照组围术期实施常规护理,观察组围术期实施循证护理;比较二组术前、术后15d、术后30d焦虑、抑郁及生活质量评分变化;置管天数、住院天数、并发症率及临床满意度。结果术前二组焦虑、抑郁及生活质量评分差异无统计学意义(P>0.05);术后15d及30d二组SAS及SDS评分均较术前均有明显降低(P<0.05);术后15d观察组患者心理、躯体、认知和社会维度评分均显著高于术前及对照组(P<0.05);术后30d观察组心理、躯体、认知、社会、角色五维度评分均显著高于术前及对照组(P<0.05);观察组置管与住院时间、并发症率均显著低于对照组(P<0.05);临床满意度显著高于对照组(P>0.05)。结论循证护理以患者为中心,用批判性思维寻求、制定护理方案并严格执行,能显著改善临床护理质量,缩短患者治疗时间、减轻患者心理和生理负担、防治并发症,在膀胱癌全切回肠代膀胱腹壁造瘘围术期实施效果显著,值得推广应用。
Objective To investigate the nursing effect of evidence-based nursing in the perioperative period of total ileal ileal bladder fistula in bladder cancer. Methods Forty-eight patients with bladder cancer undergoing total ileal ileal bladder sphincterotomy were enrolled in this study. Patients under informed consent and under informed consent were divided into observation group and control group by single and double digital grouping method (24 cases in each group). The control group received routine nursing during perioperative period and evidence-based nursing during the perioperative period. The scores of anxiety, depression and quality of life before and 15 days after operation and 30 days after operation were compared between the two groups. , Days of hospitalization, complication rate and clinical satisfaction. Results There was no significant difference in anxiety, depression and quality of life between the two groups before surgery (P> 0.05). SAS and SDS scores of the two groups were significantly lower than those before operation (P <0.05) 15d and 30d after operation The scores of psychological, physical, cognitive and social dimensions in 15d observation group were significantly higher than those in preoperative and control groups (P <0.05). On the 30th postoperative day, the five dimensions of psychological, physical, cognitive, social and role dimensions were significantly higher in observation group The preoperative and postoperative control groups (P <0.05). The time of catheterization and hospital stay in the observation group was significantly lower than that of the control group (P <0.05). The clinical satisfaction was significantly higher than that of the control group (P> 0.05). Conclusion Evidence-based nursing takes patients as the center, seeking and formulating nursing plans with critical thinking. It can significantly improve the quality of clinical nursing, shorten the treatment time of patients, reduce the psychological and physiological burden of patients, prevent and cure complication, Ileal bladder abdominal wall fistula perioperative implementation of significant results, it is worth promoting.