預見性護理對成人急性闌尾炎切除術后并發癥及生活質量的影響

皮飛飛 祝志邦

【關鍵詞】 預見性護理;急性闌尾炎;并發癥;生活質量

中圖分類號：R574.610.47?? 文獻標識碼：A?? DOI：10.3969/j.issn.1003-1383.2018.01.024

Influence of predictive nursing on complications and life quality of adults after acute appendicitis

PI Feifei，ZHU Zhibang

【Abstract】 Objective To investigate the influence of predictive nursing on complications and life quality of adults after acute appendicitis.

Methods 124 adult patients with acute appendicitis were selected as study objects，and they were divided into predictive group and control group according to the order of admission，with 62 cases in each group.The control group were given only routine nursing intervention，and based on which the predictive group were given predictive nursing intervention.Then，basic conditions of perioperative period（operation time，intraoperative bleeding volume，postoperative anus exhaust time，time to get out of bed after surgery and hospitalization time） were compared between the two groups.In addition，the quality of life （Inflammatory Bowel Disease Questionnaire，IBDQ） at 15 d after operation and the incidence of complications within 3 d after the operation were analyzed.

Results Operation time，intraoperative bleeding volume，postoperative anus exhaust time，time to get out of bed after surgery and hospitalization time of the predictive group were all obviously less than those of the control group（P<0.05）.Within 3d after operation，the difference of the occurrence rate of incision infection，postoperative bleeding，dysuresia and LDVT between the two groups was not statistically significant（P>0.05），and the occurrence rate of adhesive intestinal obstruction in the predictive group was significantly lower than that in the control group （P<0.05）.At 15 d after operation，each index score and total score of IBDQ of the predictive group were significantly higher than those in the control group（P<0.05）.

Conclusion Predictive nursing can reduce the incidence of complications after the excision of acute appendicitis in adults，and improve the quality of life of the patients after operation.

【Key words】 predictive nursing;acute appendicitis;complication;life quality

急性闌尾炎屬于常見的外科急腹癥，多發于青壯年人群，患者發病后主要表現出腹部固定部位劇烈疼痛，對其生活質量造成極大負面影響。闌尾切除術是臨床應用最為廣泛的治療急性闌尾炎的方法，但部分患者對腹腔手術認知不足，因而具有一定恐懼心理，且可能由于缺乏術后保健意識，導致并發癥頻發，因而予以有效的護理干預尤為重要。對此，本研究采取預見性護理對急性闌尾炎患者進行圍術期干預，現將結果報道如下。

1 資料與方法

1.1 一般資料

選取我院收治的124例急性闌尾炎成年患者為受試對象，按照入院順序隨機分為預見組與對照組各62例。兩組性別、年齡、疾病類型、發病至入院時間等一般資料比較均無統計學意義（P>0.05），具有可比性。見表1。

1.2 納入標準

①符合急性闌尾炎相關診斷標準且具備闌尾切除術指征者[1];②年齡為18～65歲者;③發病至入院時間≤12 h者。

1.3 排除標準

①臨床治療不全者;②存在交流、精神障礙或無法配合護理者;③有手術禁忌證或有開腹手術指征者;④隨訪期失聯者。

1.4 護理方法

兩組均予相同的手術方式。對照組患者僅實施常規護理干預，主要包括入院記錄基本臨床資料、為患者講解手術過程及注意事項、協助醫師實施手術、常規健康宣教及出院指導。預見組患者則在其基礎上予以預見性護理干預，具體方案如下：①不良情緒預防：向患者……