论著

急性缺血性脑卒中介入治疗优化护理路径的构建及应用

Development and application of an optimized nursing pathway for endovascular therapy in acute ischemic stroke

:1563-1568
 
       目的   探讨优化护理路径在急性缺血性脑卒中介入手术中的应用及效果。方法   采用随机对照研究,纳入2024年1月—2025年1月收治的112例急性缺血性脑卒中取栓患者,观察组(56例)实施优化介入护理路径,对照组(56例)采用常规护理。结果   观察组患者的满意度评分、医护满意度评分均优于对照组(P<0.05);观察组的术前等待时间、患者自进入介入室至股动脉穿刺时间、手术时间、住院费用、并发症发生率、差错事故发生率也优于对照组(P<0.05)。结论   通过标准化术前准备、术中多学科协作及术后康复衔接,优化护理路径可显著提升急性缺血性脑卒中治疗时效性(缩短急性脑卒中患者从进入医院到开始静脉溶栓给药的时间至黄金时间窗内),改善患者神经功能预后。
       Objective  To explore the application and efficacy of an optimized nursing pathway in endovascular therapy for acute ischemic stroke(AIS).Methods  A randomized controlled trial was conducted,enrolling 112 AIS patients undergoing mechanical thrombectomy from January 2024 to January 2025.Patients were randomly assigned to either the observation groupn=56),which received the optimized interventional nursing pathway,or the control group(n=56),which  received  routine nursing care.Results  Patient satisfaction score,medical staff satisfaction score,and postoperative favorable  recovery  rate in observation group were better than those of control group(P<0.05).Additionally,the observation group  showed  significant improvements in preoperative waiting time,time from entering the operation room to femoral artery puncture,surgical duration,hospitalization costs,complication incidence rate,and medical error incidence rate(P<0.05).Conclusions  By standardizing preoperative preparations,implementing intraoperative multidisciplinary collaboration,and enhancing postoperative  rehabilitation coordination,the optimized nursing pathway significantly improved the timeliness of thrombectomy treatment(shortening door-to-needle time to reach the golden time window)and enhanced neurological functional prognosis in AIS patients,demonstrating substantial clinical applicability.
论著

多学科整合护理路径联合手术室优质护理对下肢骨折的应用效果及对术后下肢静脉血栓影响

Application effect of multidisciplinary integrated nursing pathway combined with high-quality nursing in operating room for patients with lower limb fracture and its effect on postoperative lower limb venous thrombosis

:186-191
 
目的 探讨多学科整合护理路径联合手术室优质护理对下肢骨折的应用效果及对术后下肢静脉血栓发生率的影响。方法 选择2021年1月—2022年10月我院收治的70例下肢骨折患者,随机分为联合组与常规组,每组各35例。常规组患者实施常规护理,联合组患者实施多学科整合护理路径联合手术室优质护理,对比两组患者护理效果。结果 联合组患者首次下床活动时间、术后视觉模拟量表(VAS)评分低于常规组(P<0.05),二者住院时间以及引流管拔除时间比较差异无统计学意义(P>0.05);经过护理干预后,两组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均延长,血浆纤维蛋白原(FIB)降低,联合组优于常规组(P<0.05),且联合组下肢静脉血栓发生率低于常规组(0% vs 17.14%,P<0.05);联合组患者护理满意度更高(P<0.05);术后1个月两组患者日常生活活动能力(ADL)评分、Fugl-Meyer评分均升高,联合组高于常规组(P<0.05)。结论 多学科整合护理路径联合手术室优质护理可改善下肢骨折患者围术期指标和血液高凝状态,降低患者下肢静脉血栓发生率,提升护理满意度及患者远期日常生活能力、肢体运动功能。
Objective To explore the application effect of multidisciplinary integrated nursing path combined with high-quality nursing in operating room on patients with lower limb fracture and the effect on postoperative lower limb venous thrombosis.Methods From January 2021 to October 2022,70 patients with lower limb fracture admitted to our hospital were randomly divided into combination group and conventional group,with 35 cases in each group.Patients in the conventional group received routine nursing,and patients in the combined group received multidisciplinary integrated nursing path combined with high-quality nursing in the operating room.The nursing effect of the two groups was compared.Results The first time of getting out of bed in the combined group was earlier and postoperative VAS score was lower than those in the conventional group(P<0.05),and the length of hospital stay and drainage tube removal time were not significantly different between the two groups(P>0.05).After nursing intervention,the prothrombin time(PT)and activated partial thromboplastin time(APTT)of the two groups were prolonged,and the plasma fibrinogen(FIB)decreased,and the change range of the combined group was greater(P<0.05).The incidence of venous thrombosis in the combined group was significantly lower than that in the conventional group(0.00% vs 17.14%,P<0.05).The nursing satisfaction of patients in combination group was higher(P<0.05).The activities of daily living score and Fugl-Meyer score of both groups increased one month after surgery,and the combined group was higher than the conventional group(P<0.05).Conclusions Multidisciplinary integrated nursing path combined with high-quality nursing in operating room can improve perioperative indicators and blood hypercoagulability of patients with lower limb fractures,reduce the incidence of lower limb venous thrombosis,improve nursing satisfaction,long-term daily living ability and limb motor function of patients.
论著

护理路径对经皮椎管成型下腰椎间盘摘除术患者腰腿功能康复的影响

The effect of nursing path on the rehabilitation of lumbar and leg function in patients with percutaneous Laminoplasty

:111-114
 
目的 探讨腰椎间盘手术护理路径对经皮椎管成型下腰椎间盘摘除手术患者腰腿功能康复效果。方法 选择2018年1月—2019年11月住院进行经皮椎管成型下腰椎间盘摘除手术患者60例,按住院时间先后分为对照组和实验组各30例,对照组患者术后按椎间盘摘除手术给患者进行病情观察、腰腿功能康复锻炼、腰围配戴和康复护理知识宣教等护理;实验组患者在实施对照组护理措施基础上按腰椎间盘手术护理路径对患者进行有计划的康复护理知识宣教,按制定的康复护理路径对患者进行个性化康复活动训练指导。术后1周和出院时分别对患者掌握康复护理训练知识、腰椎功能障碍指数(ODI)、服务满意度进行评价。结果 实验组患者在术后首次进行康复训练时间早于对照组,差异有统计学意义(P=0.000 4);掌握康复护理知识得分实验组高于对照组,差异有统计学意义(P=0.002 3);掌握康复训练活动实验组高于对照组,差异有统计学意义(P<0.05);腰椎功能障碍指数(ODI)实验组低于对照组,差异有统计学意义(P<0.05);护理服务满意度实验组高于对照组,结果差异有统计学意义(P<0.05)。结论 椎间盘手术护理路径能促进患者早期进行康复训练,提高患者对腰椎间盘术后康复护理知识和康复训练技能的掌握,降低患者腰椎功能障碍指数,促进术后患者机体功能的康复。
Objective To explore the effect of nursing path of lumbar disc operation on the rehabilitation of lumbar and leg function in patients undergoing percutaneous laminoplasty. Methods From January 2018 to November 2019, 60 patients who were hospitalized for percutaneous laminoplasty were divided into the control group and the experimental group with 30 patients in each group according to the length of stay. The patients in the control group were given nursing care including condition observation, waist and leg function rehabilitation exercise, waist circumference wearing and rehabilitation nursing knowledge propaganda and education after the operation. On the basis of the nursing measures of the control group, patients in the experimental group received the planned rehabilitation nursing knowledge education according to the nursing path of lumbar disc operation, and individualized rehabilitation activity training guidance according to the established rehabilitation nursing path. One week after the operation and at the time of discharge, the patients' mastery of rehabilitation nursing training knowledge, lumbar dysfunction index (ODI) and service satisfaction were evaluated. Results The first time of rehabilitation training in the experimental group was earlier than that in the control group, the results were statistically significant (P=0.000 4); the score of mastering rehabilitation nursing knowledge in the experimental group was higher than that in the control group, the results were statistically significant (P=0.002 3); the experimental group of mastering rehabilitation training activities was higher than that in the control group, the results were statistically significant (P<0.05); lumbar dysfunction index ODI in the experimental group was lower than that in the control group, the results were statistically significant (P<0.05); the satisfaction of nursing service in the experimental group was higher than that in the control group, the results were statistically significant (P<0.05). Conclusion The nursing path of lumbar disc surgery can promote the early rehabilitation training of patients, improve the mastery of postoperative rehabilitation nursing knowledge and rehabilitation training skills of patients, reduce the lumbar dysfunction index of patients, and promote the rehabilitation of patients' body function.
论著

临床护理路径对二胎异位妊娠患者健康教育的应用效果

The effect of clinical nursing pathway on education in patients with ectopic pregnancy

:118-121
 
目的 探究以临床护理路径为主的健康教育在二胎异位妊娠患者中的应用效果。方法 选取2016年1月—2017年6月收治的80例二胎异位妊娠患者,随机分为实验组40例和对照组40例,实验组:实施以临床护理路径为主的健康教育,对照组以常规指导,比较两组临床效果。结果 实验组患者在健康教育知晓率、护理满意率方面与对照组比较,有差异(P<0.05);实验组在住院时间、住院费用及并发症发生率方面与对照组比较(P<0.05),观察组焦虑评分与抑郁评分均低于对照组(P<0.05)。结论 二胎异位妊娠患者运用临床护理路径进行健康教育,可有效提高患者对于异位妊娠疾病的了解程度,提高治疗护理依从性,促进患者早日康复出院,提高护理满意度,值得推广普及。
Objective To study the effect of applying clinical nursing pathway on health education of second womb ectopic pregnancy and explore more effective health education modes. Methods 80 patients with second-trimester ectopic pregnancy were randomly divided into experimental group (40 cases) and control group (40 cases). The experimental group was given health education through clinical nursing pathway. The control group was given routine guidance. We compared the effects of health education in two groups. Results 40 patients in the experimental group were compared with the 40 patients in the control group in terms of awareness rate of health education and satisfaction rate of care, P<0.05; the experimental group was compared with the control group in terms of length of stay, hospitalization costs, and complication rate, P<0.05 The anxiety scores and depression scores in the observation group were lower than those in the control group, P<0.05. There was a statistical difference between the two groups. Conclusions Applying clinical nursing pathway on health education of second womb ectopic pregnancy patients may effectively improve patients' understanding of ectopic pregnancy diseases, improve compliance of nursing care, facilitate patients to be discharged and improve satisfaction of nursing satisfaction, clinical care services in the popularization.
出版者信息








《广州医药》公众号