肝硬化食管静脉曲张出血手术患者的综合护理。

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Wen-Xiu Su, Yun-Fei Li, Yi-Jun Zhu, Di-Wen Li
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引用次数: 0

摘要

背景:在全球范围内,肝硬化是第14大死亡原因,对人类健康构成重大威胁。目的:探讨综合医疗系统中多学科协作模式对肝硬化食管静脉曲张出血(EVB)手术患者术后恢复和心理应激的影响。方法:在2022年1月至2024年3月期间,共收治180例肝硬化和EVB患者,随机分为对照组(标准治疗)和观察组(标准治疗加多学科合作模式),每组90例。术后恢复指标(症状改善时间、开始进食时间、肠道健康恢复时间、首次放屁时间、住院时间)、心理应激反应[焦虑自评量表(SAS)];比较两组患者抑郁自评量表(SDS)、主观幸福感和并发症发生率。结果:与对照组相比,观察组患者症状改善早,恢复进食早,肠音恢复早,首次排气早,住院时间短。干预前SAS、SDS评分组间差异无统计学意义,干预后观察组评分显著低于对照组。同样,两组在干预前的主观幸福感得分也没有显著差异。干预后两组得分均有所提高,观察组得分显著高于对照组。结论:观察组患者并发症发生率较低。因此,对于接受EVB手术的肝硬化患者,在综合医疗体系内的多学科协作模式可以促进术后早期恢复,减少心理压力,提高主观幸福感,减少并发症和再出血。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nursing care for patients with liver cirrhosis undergoing surgery for esophageal variceal bleeding in an integrated healthcare system.

Background: Globally, Liver cirrhosis is the 14th leading cause of death and poses a significant threat to human health.

Aim: To investigate the effects of a multidisciplinary collaboration model on postoperative recovery and psychological stress in patients with liver cirrhosis undergoing esophageal variceal bleeding (EVB) surgery within an integrated healthcare system.

Methods: Between January 2022 and March 2024, a total of 180 patients with cirrhosis and EVB were admitted and randomly assigned to either a control group (standard care) or an observation group (standard care plus the multidisciplinary collaboration model), with 90 patients in each group. Postoperative recovery indicators (time to symptom improvement, time to start eating, time to bowel sound recovery, time to first flatus, and hospital stay), psychological stress responses [self-rating anxiety scale (SAS); self-rating depression scale (SDS)], subjective well-being, and incidence of complications were compared between the two groups.

Results: Compared to the control group, the observation group showed earlier symptom improvement, earlier return to eating, bowel sound recovery, first flatus, and a shorter hospital stay. Pre-intervention SAS and SDS scores were not significantly different between the groups, but post-intervention scores were significantly lower in the observation group. Similarly, there was no significant difference in the subjective well-being scores before the intervention between the two groups. After the intervention, both groups showed improved scores, with the observation group scoring significantly higher than the control group.

Conclusion: The observation group also had a lower incidence of complications. Therefore, for patients with liver cirrhosis undergoing EVB surgery, a multidisciplinary collaboration model within an integrated healthcare system can promote early postoperative recovery, reduces psychological stress, improves subjective well-being, and reduces complications and rebleeding.

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