摘要
目的:探讨医护患一体化护理干预在经脐单孔腹腔镜全子宫切除术(LTH)患者围术期应用价值。方法:选取2022年1月-2023年12月本院拟行经脐单孔LTH患者134例,依据入院时间分为两组,各67例。常规组实施围术期常规护理干预,一体化组予以医护患一体化护理干预。比较两组术后各时点视觉模拟评分法(VAS)评分、并发症发生率、21项简版抑郁-焦虑-压力量表(DASS-21)评分、医学应对方式问卷(MCMQ)评分。结果:两组均顺利完成经脐单孔LTH,干预期间常规组术后失访1例,资料不全1例,纳入65例;一体化组个人因素退出1例,纳入66例。术后6 h、1 d、2 d、3 d一体化组VAS评分均低于常规组,焦虑(6.02±1.14分)、压力(5.23±1.13分)及抑郁(6.83±1.45分)得分均低于常规组(8.31±1.47分、7.78±1.64分、9.02±2.10分),MCMQ面对维度得分(22.38±3.14分)高于常规组(19.61±3.25分),屈服(10.32±2.36分)与回避(12.49±2.63分)维度得分低于常规组(12.45±2.73分、15.07±3.13分),手术并发症发生率(4.6%)低于常规组(15.4%)(均P<0.05)。结论:医护患一体化护理干预应用于经脐单孔LTH患者,可减轻术后疼痛,调节负性情绪,改变患者应对方式,降低并发症风险。
Objective: To investigate the clinical value of the integrated nursing intervention of doctors, nurses and patients for patients with transumbilical single hole laparoscopic total hysterectomy(LTH). Methods: 134 patients who wanted the transumbilical single hole LTH were selected and were divided into two groups(67 cases in each group) according to the admission time from January 2022 to December 2023. The patients in the control group received the perioperative routine nursing intervention, and the patients in the study group received the integrated nursing intervention of doctors, nurses and patients. The score of visual analogue score(VAS) at the postoperative different time points, the complication rate, and the scores of depression-anxiety-stress scale-21(DASS-21) and the medical coping modes questionnaire(MCMQ) of the patients were compared between the two groups. Results: The patients in both groups had successfully completed the transumbilical single hole LTH. During the intervention period, 65 cases were included in the control group except to 1 case with lost to follow-up and 1 case without the complete data, and 66 cases were included in the study group except to 1 case withdrew due to personal factors. The VAS scores of the patients in the study group at the 6th h, at the 1st d, in the 2 second day and in the 3 third day after operation were significantly lower than those of the patients in the control group. The scores of anxiety(6.02±1.14 points), stress(5.23±1.13 points) and depression(6.83±1.45 points) of the patients in the study group were significantly lower than those(8.31±1.47 points, 7.78±1.64 points and 9.02±2.10 points) of the patients in the control group. The MCMQ confrontation dimension score(22.38±3.14 points) of the patients in the study group was significantly higher than that(19.61±3.25 points)of the patients in the control group.The scores of yield(10.32±2.36points)and avoidance(12.49±2.63points)of the patients in the study group were significantly lower than those(12.45±2.73points and 15.07±3.13points)of the patients in the control group.The incidence of the surgical complications(4.6%)of the patients in the study group was significantly lower than that(15.4%)of the patients in the control group(all P<0.05).Conclusion:The integrated nursing intervention of doctors,nurses and patients applied to the patients with transumbilical single hole LTH can alleviate their postoperative pain,regulate their negative emotions,change their coping style,and reduce the risk of their complications.
作者
高青青
马满瑞
杨莉
毛丽
马玉鹤
左鹏
GAO Qingqing;MA Manrui;YANG Li;MAO Li;MA Yuhe;ZUO Peng(Peking University People's Hospital,Beijing,101100)
出处
《中国计划生育学杂志》
2025年第2期325-330,共6页
Chinese Journal of Family Planning
关键词
经脐单孔腹腔镜全子宫切除术
医护患一体化护理干预
术后疼痛
负性情绪
应对方式
并发症
Transumbilical single hole laparoscopic total hysterectomy
Integrated nursing intervention of doctors,nurses and patients
Postoperative pain
Negative emotion
Coping style
Complication
