目的 探讨叙事护理在老年疼痛患者中的应用效果。方法 根据随机数字表法将84例于2020年12月—2023年12月中国人民解放军南部战区总医院收治的患有恶性肿瘤的老年疼痛患者分为接受常规干预的对照组(n=42)和接受叙事护理的观察组(n=42),比较两组疼痛情况、负性情绪、睡眠状况及自我效能。结果 观察组在干预2、4、6、8周后疼痛数字分级评分分别为(5.02±1.07)(4.26±0.76)(3.58±0.65)(2.92±0.41)分,均低于对照组(t分别为2.126、2.419、3.232、2.545,P均<0.05);干预2个月后,观察组焦虑、抑郁自评量表评分、匹兹堡睡眠质量指数分别为(41.27±2.28)(42.47±3.19)(5.13±1.46)分,均低于对照组(t分别为11.795、9.669、3.579,P均<0.05),一般自我效能量表评分为(21.72±4.13)分,高于对照组(t=5.834,P<0.05)。结论 叙事护理可有效控制老年癌性疼痛患者的疼痛,显著改善负性情绪和睡眠状况,有利于自我效能的提升。
Objective To explore the application effect of narrative nursing in elderly patients with pain.Methods From December 2020 to December 2023,84 elderly patients with malignant tumor in the General Hospital of the Southern Theater Command of the People’s Liberation Army of China were randomly divided into control group(n=42)receiving routine intervention and observation group(n=42)receiving narrative nursing.Results The pain digital grading scores of the observation group at 2 weeks,4 weeks,6 weeks and 8 weeks after intervention were(5.02±1.07),(4.26±0.76),(3.58±0.65)and(2.92±0.41),which were lower than the control group(t=2.126,2.419,3.232,2.545,all P<0.05).After 2 months of intervention,the scores of Self-Rating Anxiety Scale,Self-Rating Depression Scale and Pittsburgh Sleep Quality Index in the observation group were(41.27±2.28),(42.47±3.19)and(5.13±1.46),which were lower than the control group(t=11.795,9.669,3.579,P<0.05).The score of general self-efficacy scale was(21.72±4.13),which was higher than the control group(t=5.834,P<0.05).Conclusions Narrative nursing can effectively control the pain of elderly patients with cancer pain,significantly improve negative emotions and sleep status,and is conducive to the improvement of self-efficacy.
目的 基于最佳矫正视力(BCVA)、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼(AACG)的疗效。方法 回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象,依据1∶1匹配原则,将接受常规小梁切除术的56例患者作为对照组,接受改良小梁切除术的56例患者作为观察组,统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果 术后3个月,观察组视力为(0.63±0.04)logMAR,高于对照组(0.50±0.03)logMAR,眼压为(16.22±2.28)mmHg,低于对照组(19.95±2.31)mmHg(t=19.457、8.600,均P<0.05);观察组浅前房发生率为8.93%,低于对照组的26.79%(χ 2 =6.087,P=0.014);观察组角膜水肿状况优于对照组(Z=2.737,P=0.006);观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%,均低于对照组17.86%、23.21%、32.14%、35.71%(χ 2 =8.166、7.292、3.953、9.818,均P<0.05)。结论 较常规小梁切除术,改良小梁切除术治疗AACG患者,有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生,且安全性较高。
Objective To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma(AACG)based on best-corrected visual acuity(BCVA)and degree of corneal edema.Methods A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects.According to the 1∶1 matching principle,56 patients receiving conventional trabeculectomy were selected as control group,and 56 patients receiving modified trabeculectomy were selected as observation group.Perioperative BCVA,intraocular pressure,postoperative shallow anterior chamber formation,degree of corneal edema and complications were analyzed.Results At three months postoperatively,visual acuity in the observation group was(0.63±0.04)logMAR,which was higher than that in the control group(0.50±0.03)logMAR,and intraocular pressure was(16.22±2.28)mmHg,which was lower than that in the control group(19.95±2.31)mmHg(t=19.457,8.600,P<0.05);the incidence of shallow anterior chamber in the observation group was 8.93%,which was lower than that of the control group(26.79%)(χ 2 =6.087,P=0.014);the corneal edema status in the observation group was better than that of the control group(Z=2.737,P=0.006);the rates of choroidal detachment,filtering channel obstruction,hyphema,and iris inflammation in the observation group were 1.79%,5.36%,16.07%,and 10.71%,respectively,which were lower than those of the control group(17.86%,23.21%,32.14%,and 35.71%)(χ 2 =8.166,7.292,3.953,and 9.818,P<0.05).Conclusions Compared with conventional trabeculectomy,modified trabeculectomy can improve visual acuity,reduce intraocular pressure,relieve corneal edema,and reduce the occurrence of shallow anterior chamber in patients with AACG,with higher safety.