Application value of multidisciplinary collaborative clinical nursing pathway for patients with complex intrahepatic bile duct stones undergoing laparoscopic biliary surgery
Objective To investigate the value of multidisciplinary collaborative clinical nursing pathway(CNP)in laparo-scopic biliary surgery for patients with complex intrahepatic bile duct stones(CIBDS).Methods CIBDS patients underg-one with laparoscopic biliary tract surgery were selected in Henan Provincial People's Hospital from 2021 to 2022 as the research subjects.Fifty-two patients with CIBDS admitted from January 1,2021 to December 31,2021 were included as the routine group,and 52 patients with CIBDS admitted from January 1,2022 to December 31,2022 were included as the CNP group in a ratio of 1∶1 matching.The routine group adopted the routine nursing intervention strategy,and the CNP group adopted the multi-disciplinary collaborative CNP intervention strategy based on the routine nursing.The postopera-tive recovery(first time out of bed activity,first urination time,first exhaust time,total hospitalization days),periopera-tive comfort,postoperative compliance behavior,self-care ability[self-care ability scale(ESCA)],psychological state[self-rating depression scale(SDS)and self-rating anxiety scale(SAS)],and incidence of complications were compared between the two groups.Results In CNP group,the first exhaust time was(16.11±1.67)h,which was shorter than that in rou-tine group(20.96±2.23)h,t=12.553,P＜0.001;the first time out of bed activity was(2.62±0.51)d,which was shorter than that in routine group(3.46±1.01)d,t=5.354,P＜0.001;the total hospitalization days was(6.21± 1.03)d,which was shorter than that in routine group(8.53±2.11)d,t=7.125,P＜0.001.In CNP group,the perio-perative physiological score was(33.12±3.20)points,which was higher than that in routine group(25.04±2.75)point,t=13.809,P＜0.001;psychological score was(30.24±3.16)points,which was higher than that in routine group(24.61±2.59)points,t=9.937,P＜0.001;environmental score was(28.91±2.12)points,which was higher than that in routine group(22.76±2.81)points,t=12.599,P＜0.001;cultural score was(17.69±2.45)points,which was higher than that in the routine group(12.13±1.62)points,t=13.651,P＜0.001.In CNP group,the compliance with medical behavior score was(7.92±1.24)points,which was higher than that in routine group(6.62±2.01)points,t=3.969,P＜0.001;appropriate exercise score was(7.56±1.62)points,which was higher than that in routine group(5.98±1.20)points,t=5.652,P＜0.001;regular rest behavior score was(8.19±1.07)points,which was higher than that in routine group(6.41±1.86)points,t=5.982,P＜0.001.After intervention,in CNP group,the ESCA score was(130.38±10.21)points,which was higher than that in routine group(119.73±8.91)points,F=15.940,P＜0.001;SDS score was(35.25±5.25)points,which was lower than that in the routine group(43.92±6.29)points,F=29.380,P＜0.001;SAS score was(30.25±4.61)points,which was lower than that in the routine group(41.15±5.20)points,F=63.978,P＜0.001.The complication rate of CNP group was 5.77％,which was significantly lower than that of routine group 19.23％(x2=4.308,P=0.038).Conclusion Multidisciplinary CNP can improve the perioperative comfort and negative emotion of CIBDS patients undergoing laparoscopic biliary tract surgery,promote their compliance behavior and self-care ability,reduce postoperative complications,and promote rapid postoperative recovery.
multidisciplinary collaborationclinical nursing pathwaycomplex intrahepatic bile duct calculuslaparoscopic biliary tract surgery
NETL
NSTL
万方数据
