目的:探讨基于多维危机控制理念的围术期管理对老年内镜下逆行胰胆管造影术(ERCP)患者应对方式和并发症的影响。方法:将2019年10月-2022年1月在我院实施ERCP术的98例老年患者作为研究对象。根据入院时间的不同将2019年10月～2020年11月在本院行ERCP术治疗的45例老年患者作为对照组，将2020年12月～2022年1月在本院行ERCP术治疗的53例老年患者作为观察组。对照组予以常规护理干预，观察组予以基于多维危机控制理念的围术期管理，均持续干预至患者出院。记录两组患者术后恢复指标(住院时间、首次下床时间及首次肛门排气时间)。于干预前后，对比两组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分、自护能力量表(ESCA)和应对方式评分;采用视觉模拟评分(VAS)评估患者术后不同时间的疼痛程度，并记录患者并发症发生情况和患者的护理满意度。结果:观察组患者住院时间、首次下床时间及首次肛门排气时间均显著短于对照组(P＜0。05);干预后，观察组HAMD、HAMA评分均显著低于对照组(P＜0。05);干预后，两组ESCA、积极应对评分均升高，消极应对评分均降低，且观察组ESCA、积极应对评分高于对照组，消极应对评分低于对照组(P＜0。05);在术后2h、6h、12h，观察组的VAS评分均显著低于对照组(P＜0。05);观察组并发症发生率为15。09％，显著低于对照组的40。00％(P＜0。05)。观察组护理满意度高于对照组(92。45％ vs 77。78％)(P＜0。05)。结论:基于多维危机控制理念的围术期管理模式可改善老年ERCP患者心理状态，改变应对方式，缓解疼痛程度，降低并发症发生率，促进术后恢复。
The Impact of Perioperative Management Based on the Concept of Multidimensional Cri-sis Control on the Coping Styles and Complications of Elderly ERCP Patients
Objective:To investigate the effect of comprehensive nursing under the core concept of multidimensional crisis control concept on perioperative psychological stress and complications of elderly patients undergoing endoscopic retrograde cholangiopancrea-tography(ERCP).Methods:A total of 98 elderly patients who underwent ERCP in our hospital from October 2019 to January 2022 were selected and divided into observation group(n=53)and control group(n=45)by simple random method.The control group received routine nursing intervention,and the observation group received all-round nursing under the JCI core concept,and continued interven-tion until the patients were discharged.The postoperative recovery indicators(hospitalization time,first time out of bed,and first anal exhaust time)of the two groups of patients were recorded.Before and after intervention,depression and anxiety were assessed by Hamil-ton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA).and exercise of self-care agency scale(ESCA),and pain was as-sessed by visual analog scale(VAS).The incidence of postoperative complications and patient care satisfaction were compared be-tween the two groups.Results:The hospitalization time,first time out of bed and first anal exhaust time of patients in the observation group were significantly shorter than those in the control group(P＜0.05).After intervention,the scores of HAMD,HAMA and VAS in observation group were significantly lower than those in control group(P＜0.05).After the intervention,the ESCA and positive coping scores of both groups increased,and the negative coping scores decreased.The ESCA and positive coping scores of the observation group were higher than those of the control group,while the negative coping scores of the observation group were lower than those of the control group(P＜0.05).At 2 h,6 h,and 12 h after surgery,the VAS scores of the observation group were significantly lower than those of the control group(P＜0.05);the incidence of complications in the observation group was 15.09％,which was significantly low-er than the 40.00％of the control group(P＜0.05).The nursing satisfaction of the observation group was higher than that of the control group(92.45％ vs 77.78％)(P＜0.05).Conclusion:Multidimensional crisis control concept is beneficial to improve the mental state,changing coping styles,and alleviating pain levels of elderly ERCP patients,reduce the incidence of complications,and promote pa-tients to recover quickly.
Multidimensional Crisis Control ConceptPerioperative ManagementEndoscopic Retrograde Cholangiopancreatogra-phyMental StatePainComplicationsSolution
万方数据
维普
