發(fā)布時間：2019-05-28 08:27

【摘要】：目的:(1)參考美國東南外科護理協(xié)會制定的臨床護理路徑表,結(jié)合肝硬化食管靜脈曲張?zhí)自g(shù)患者的病情及治療護理特點,制定肝硬化食管靜脈曲張?zhí)自g(shù)的臨床護理路徑表,并分析臨床護理路徑在肝硬化食管靜脈曲張?zhí)自g(shù)患者中的可行性。(2)將制定的臨床護理路徑表應(yīng)用于肝硬化食管靜脈曲張?zhí)自g(shù)患者中,按照路徑表的內(nèi)容進行有針對性、有步驟地治療及護理,觀察臨床護理路徑在肝硬化食管靜脈曲張?zhí)自g(shù)患者中的應(yīng)用效果。方法:(1)引進美國東南外科護理協(xié)會制定的臨床護理路徑表,比對路徑表里的內(nèi)容,從治療、飲食、護理等方面綜合分析,根據(jù)肝硬化食管靜脈曲張?zhí)自g(shù)患者自身的特點制定相應(yīng)的臨床護理路徑表,征求護理專家的意見進行修改,并選取一定數(shù)量的患者進行預(yù)試驗,分析臨床護理路徑在肝硬化食管靜脈曲張?zhí)自g(shù)患者中的可行性。(2)將符合納入排除標(biāo)準(zhǔn)的-胃鏡下行食管靜脈曲張?zhí)自g(shù)的肝硬化患者90例隨機分為兩組。對照組采用常規(guī)護理,包括入院指導(dǎo)、病情觀察、健康教育、飲食護理、用藥護理等;觀察組將護理路徑小組制定的護理路徑表應(yīng)用于肝硬化食管靜脈曲張?zhí)自g(shù)的患者中,對實施臨床護理路徑的護士進行培訓(xùn),由經(jīng)過培訓(xùn)的責(zé)任護士按照路徑表的內(nèi)容進行有針對性、有步驟地治療及護理。比較兩組患者的再出血發(fā)生率、患者滿意度、住院時間、住院費用和健康教育知識掌握情況等,將兩組的比較結(jié)果進行分析、總結(jié),從而得到護理路徑的使用效果。結(jié)果:(1)食管靜脈曲張?zhí)自g(shù)的臨床護理路徑表能夠體現(xiàn)此病種的疾病護理特點、比較合理,路徑表中的治療和護理措施均能對患者起到比較顯著的效果,值得進一步推廣使用。(2)本研究觀察組患者的再出血發(fā)生率為4.4%,低于對照組的17.8%,差異有統(tǒng)計學(xué)意義(P0.05);觀察組的住院時間為8.2±2.7,住院費用為14922.5±4424.8,也均低于對照組,差異有統(tǒng)計學(xué)意義(P0.05);觀察組患者的滿意度為97.8%,明顯要高于對照組的82.2%,差異有統(tǒng)計學(xué)意義(P0.05);觀察組患者的健康知識得分為25.2±2.0,高于對照組的22.4±2.1,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:(1)本研究制定的肝硬化食管靜脈曲張?zhí)自g(shù)的護理路徑表合理,肝硬化食管靜脈曲張?zhí)自g(shù)患者中應(yīng)用護理路徑的方法可行。(2)臨床護理路徑在食管靜脈曲張?zhí)自g(shù)患者中的應(yīng)用可以顯著降低患者的再出血發(fā)生率,縮短患者住院時間及降低患者住院費用,減少醫(yī)療護理支出;加強患者對治療護理工作的依從性,主動配合治療護理工作,提高患者滿意度,對患者的治療護理有積極作用。
[Abstract]:Objective: (1) to refer to the clinical nursing pathway list developed by Southeast Surgical Nursing Association of the United States, combined with the condition and characteristics of treatment and nursing of patients with cirrhotic esophageal varices. To establish the clinical nursing pathway table of esophageal variceal ligature in cirrhotic patients. The feasibility of clinical nursing pathway in patients with cirrhotic esophageal varices was analyzed. (2) the clinical nursing pathway table was applied to patients with cirrhotic esophageal varices. According to the contents of the path table, the treatment and nursing were carried out step by step, and the application effect of clinical nursing pathway in patients with cirrhotic esophageal varices was observed. Methods: (1) the clinical nursing pathway table made by Southeast Surgical Nursing Association of the United States was introduced, and the contents of the path table were compared, and the comprehensive analysis was made from the aspects of treatment, diet, nursing and so on. According to the characteristics of patients with cirrhotic esophageal varices, the corresponding clinical nursing pathway table was made, the opinions of nursing experts were consulted and modified, and a certain number of patients were selected for pre-trial. To analyze the feasibility of clinical nursing pathway in cirrhotic patients with esophageal variceal ligature. (2) 90 patients with liver cirrhosis undergoing esophageal variceal ligature under gastroscopy were randomly divided into two groups. The control group was treated with routine nursing, including admission guidance, condition observation, health education, diet nursing, medication nursing and so on. In the observation group, the nursing path table developed by the nursing pathway group was applied to the patients with cirrhotic esophageal variceal ligature, and the nurses who implemented the clinical nursing pathway were trained. Trained responsible nurses according to the contents of the path table targeted, systematic treatment and nursing. The incidence of rebleeding, patient satisfaction, hospitalization time, hospitalization expenses and knowledge of health education were compared between the two groups. The comparative results of the two groups were analyzed and summarized, so as to obtain the effect of nursing path. Results: (1) the clinical nursing pathway table of esophageal variceal ligature can reflect the nursing characteristics of this disease, and it is more reasonable. The treatment and nursing measures in the path table can play a more significant effect on the patients. It is worth further popularizing and using. (2) the incidence of rebleeding in the observation group was 4.4%, which was lower than that in the control group (17.8%), the difference was statistically significant (P 0.05). The hospitalization time and cost of the observation group were 8.2 鹵2.7 and 14922.5 鹵4424.8, respectively, which were also lower than those of the control group (P 0.05). The satisfaction rate of the patients in the observation group was 97.8%, which was significantly higher than that in the control group (82.2%), the difference was statistically significant (P 0.05). The score of health knowledge in the observation group was 25.2 鹵2.0, which was significantly higher than that in the control group (22.4 鹵2.1) (P 0.05). Conclusion: (1) the nursing path table of esophageal variceal ligature in cirrhotic patients is reasonable. It is feasible to apply nursing pathway in patients with cirrhotic esophageal varices. (2) the application of clinical nursing pathway in patients with esophageal varices can significantly reduce the incidence of rebleeding. Shorten the hospitalization time of patients and reduce the hospitalization expenses of patients, reduce the expenditure of medical and nursing care; Strengthening patients' compliance to treatment and nursing work, actively cooperating with treatment and nursing work, improving patient satisfaction, and playing a positive role in patients' treatment and nursing.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.6

【參考文獻】

相關(guān)期刊論文 前10條

1 葉俊釗;鐘碧慧;;非酒精性脂肪性肝病合并糖尿病的治療[J];中華糖尿病雜志;2016年09期

2 趙艷晶;李蓮娣;王瑩;劉卓;;肝硬化合并上消化道大出血患者急救護理體會[J];中國現(xiàn)代醫(yī)生;2016年18期

3 張軍麗;;臨床護理路徑在腦梗死患者康復(fù)中的效果分析[J];中國實用醫(yī)藥;2016年17期

4 張怡;;臨床護理路徑在病毒性肝炎肝硬化并消化道出血患者中的應(yīng)用[J];中國醫(yī)藥指南;2016年04期

5 粟春林;陳擁軍;;肝硬化患者的營養(yǎng)狀況評估方法的研究進展[J];中外醫(yī)學(xué)研究;2016年02期

6 練滿嬌;;臨床護理路徑在病毒性肝炎肝硬化合并消化道出血患者中的應(yīng)用效果分析[J];內(nèi)科;2015年05期

7 馮新霞;;淺談臨床護理路徑在病毒性肝炎肝硬化并消化道出血患者中的應(yīng)用[J];中國實用醫(yī)藥;2015年28期

8 楊美英;;肝硬化合并上消化道出血患者的臨床護理研究[J];現(xiàn)代診斷與治療;2015年16期

9 沈碧強;黃珍康;;預(yù)見性及針對性護理對肝硬化合并上消化道出血患者的影響[J];齊齊哈爾醫(yī)學(xué)院學(xué)報;2015年11期

10 劉美鳳;黃慧懿;;應(yīng)用臨床護理路徑對肝硬化病人健康教育的探討[J];全科護理;2015年08期

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