个体化综合护理模式辅助内镜下黏膜切除术治疗结肠息肉的效果观察

徐瑞霞; 洪燕玲; 江吴霞; 周燕

doi:10.16766/j.cnki.issn.1674-4152.003822

个体化综合护理模式辅助内镜下黏膜切除术治疗结肠息肉的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003822

丽水市中心医院消化内科，浙江丽水 323000

基金项目:

浙江省医药卫生科技计划项目 2021ZH077

详细信息

通讯作者:
徐瑞霞，E-mail：sysy990@126.com

中图分类号: R574.62 R473.6
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- 文章访问数: 18
- HTML全文浏览量: 10
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-09
- 网络出版日期: 2025-01-20

The effect of personalized comprehensive nursing on endoscopic mucosal resection in patients with colonic polyps

Department of Gastroenterology, Lishui Central Hospital, Lishui, Zhejiang 323000, China

摘要

摘要: 目的探讨个体化综合护理模式对行内镜下黏膜切除术(EMR)治疗结肠息肉患者的护理效果，分析其对患者住院期间手术相关指标、疼痛和负性情绪、术后并发症发生率及护理满意度的影响。方法选取丽水市中心医院2021年9月—2022年11月收治的结肠息肉拟行EMR患者118例为研究对象，采用随机数字表法分为对照组(59例)和观察组(59例)。对照组采用常规护理，观察组采用个体化综合护理。比较2组患者EMR手术相关指标、疼痛和负性情绪变化、并发症发生率和对护理的满意度。结果观察组术中出血量、术后首次排气时间、术后首次排便时间、术后首次下床时间、住院时间均低于对照组(P<0.05)。护理后观察组VAS评分[(1.96±0.80)分vs. (3.36±1.37)分]、焦虑自评量表(SAS)评分[(32.61±3.75)分vs. (36.98±4.70)分]和抑郁自评量表(SDS)评分[(30.20±4.23)分vs. (34.50±2.69)分]均低于对照组(P<0.05)。观察组并发症发生率(10.2%，6/59)低于对照组(27.1%, 16/59，P<0.05)。观察组护理总满意率(89.8%，53/59)高于对照组(74.6%, 44/59，P<0.05)。结论个体化综合护理模式可以缩短结肠息肉行EMR患者术后恢复时间，缓解术后疼痛，促进患者情绪恢复，减少并发症，提高护理满意度。
- 个体化综合护理 /
- 结肠息肉 /
- 内镜下黏膜切除术 /
- 疼痛 /
- 焦虑 /
- 抑郁
Abstract: Objective To investigate the effect of personalized comprehensive nursing on endoscopic mucosal resection (EMR) in patients with colonic polyps and analyze surgical-related indicators, postoperative pain, negative emotions, postoperative complications rate, and nursing satisfaction during hospitalization. Methods A total of 118 colonic polyps patients who underwent EMR at Lishui Central Hospital from September 2021 to November 2022 were selected and divided into a control group (59 cases) and an observation group (59 cases) using the digital table method. The control group received the routine procedure, while the observation group received personalized comprehensive nursing. Surgical-related indicators, postoperative pain, negative emotions, postoperative complications rate, and nursing satisfaction were compared between the two groups. Results Compared with the control group, the observation group showed significantly reduced intraoperative blood loss, time to first exhaust, time to first defecation, time to first activity out of bed, and hospitalization time (P<0.05). After nursing, the visual analogue scale (VAS) score [(1.96±0.80) points vs. (3.36±1.37) points], self-rating anxiety scale (SAS) score [(32.61±3.75) points vs. (36.98±4.70) points], and self-rating depression scale (SDS) score [(30.20±4.23) points vs. (34.50±2.69) points] in the observation group were lower than those in the control group (P<0.05). Moreover, the observation group had a significantly lower postoperative complications rate [10.2% (6/59) vs. 27.1% (16/59)] and higher nursing satisfaction rate [89.8% (53/59) vs. 74.6% (44/59)] compared to the control group (P<0.05). Conclusion Personalized comprehensive nursing model can shorten the postoperative recovery time, reduce postoperative pain, promote emotional recovery, reduce postoperative complications, and enhance nursing satisfaction in colonic polyp patients undergoing EMR.
- Personalized comprehensive nursing /
- Colon polyps /
- Endoscopic mucosal resection /
- Pain /
- Anxiety /
- Depression

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表 1 2组结肠息肉患者基本资料比较

Table 1. Comparison of basic characteristics between the two groups of colonic polyps patients

项目	对照组(n=59)	观察组(n=59)	统计量	P值
性别[例(%)]			1.397^a	0.237
男性	38(64.4)	41(69.5)
女性	21(35.6)	18(30.5)
年龄(x±s, 岁)	61.06±10.23	59.62±12.12	0.697^b	0.486
基础疾病[例(%)]
高血压	13(22.0)	11(18.6)	0.209^a	0.647
糖尿病	7(11.9)	9(15.3)	0.289^a	0.591
慢性阻塞性肺疾病	8(13.6)	7(11.9)	0.076^a	0.782
心脑血管疾病	3(5.1)	2(3.4)	< 0.001^a	0.999
病变部位[例(%)]			0.779^a	0.677
右半结肠	14(23.7)	15(25.4)
横结肠	8(13.6)	5(8.5)
左半结肠	37(62.7)	39(66.1)
形态学[例(%)]			0.567^a	0.753
有蒂	18(30.5)	21(35.6)
亚蒂	12(20.3)	13(22.0)
扁平或广基	29(49.2)	25(42.4)
注：^a为χ²值，^b为t值。

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表 2 2组结肠息肉患者手术相关指标比较(x±s)

Table 2. Comparison of surgical-related indicators between the two groups of colonic polyps patients(x±s)

组别	例数	手术时间 (min)	术中出血量 (mL)	术后首次排气时间(h)	术后首次排便时间(h)	术后首次下床时间(h)	住院时间 (d)
对照组	59	16.05±3.64	7.04±0.91	2.81±1.07	24.56±4.53	4.04±1.25	4.76±2.10
观察组	59	14.89±3.38	5.63±0.85	2.34±0.64	20.67±3.64	2.34±0.47	3.88±2.06
t值		1.780	8.608	2.854	5.134	9.702	2.294
P值		0.075	< 0.001	0.005	< 0.001	< 0.001	0.023

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表 3 2组结肠息肉患者疼痛及负性情绪比较(x±s, 分)

Table 3. Comparison of postoperative pain and negative emotions between the two groups of colonic polyps patients (x±s, points)

组别	例数	VAS评分		SAS评分		SDS评分
组别	例数	护理前	护理后	护理前	护理后	护理前	护理后
对照组	59	4.89±2.24	3.36±1.37^b	59.14±7.53	36.98±4.70^b	55.11±6.67	34.50±2.69^b
观察组	59	4.85±1.95	1.96±0.80^b	58.57±6.96	32.61±3.75^b	56.48±5.98	30.20±4.23^b
统计量		0.124^a	5.075^c	0.427^a	9.156^c	1.184^a	8.505^c
P值		0.898	0.026	0.670	0.003	0.238	0.004
注：^a为t值，^c为F值；与同组护理前比较，^bP<0.05。

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表 4 2组结肠息肉患者术后并发症发生率比较[例(%)]

Table 4. Comparison of postoperative complications rates between the two groups of colonic polyps patients [cases (%)]

组别	例数	出血	穿孔	发热	感染	腹痛	合计
对照组	59	3(5.1)	0	4(6.8)	2(3.4)	7(11.9)	16(27.1)
观察组	59	1(1.7)	0	1(1.7)	0	4(6.8)	6(10.2)
注：2组术后并发症发生率比较，χ²=5.587，P=0.018。

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表 5 2组结肠息肉患者护理总满意率比较[例(%)]

Table 5. Comparison of nursing satisfaction rates between the two groups of colonic polyps patients [cases (%)]

组别	例数	非常满意	基本满意	不满意	总满意
对照组	59	27(45.8)	17(28.8)	15(25.4)	44(74.6)
观察组	59	36(61.0)	17(28.8)	6(10.2)	53(89.8)
注：2组护理总满意率比较，χ²=4.692，P=0.030。

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