医学新知2024,Vol.34Issue(8) :852-860.DOI:10.12173/j.issn.1004-5511.202405003

基于症状管理理论的精准护理模式在经括约肌间切除术后患者中的应用

Application of precision care model based on symptom management theory for patients after intersphincteric resection

殷燕 张洁 何文斌 段静 李思思 江从庆 解萧宇 胡小娜 谢慧瑄 骆曼 孙文
医学新知2024,Vol.34Issue(8) :852-860.DOI:10.12173/j.issn.1004-5511.202405003

基于症状管理理论的精准护理模式在经括约肌间切除术后患者中的应用

Application of precision care model based on symptom management theory for patients after intersphincteric resection

殷燕 1张洁 2何文斌 3段静 3李思思 3江从庆 3解萧宇 3胡小娜 3谢慧瑄 3骆曼 3孙文3
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作者信息

  • 1. 武汉大学中南医院创面/造口诊疗中心(武汉 430071)
  • 2. 武汉大学中南医院离退休工作处(武汉 430071)
  • 3. 武汉大学中南医院结直肠肛门外科(武汉 430071)
  • 折叠

摘要

目的 基于症状管理理论构建经括约肌间切除术后患者精准护理模式,评价其应用效果.方法 采用非随机同期对照研究设计,前瞻性选取2023年6月至2024年3月在武汉大学中南医院结直肠肛门外科行经括约肌间切除术的患者为研究对象,按照入院时间先后分为对照组与试验组.对照组实施常规护理,试验组在常规护理的基础上实施基于症状管理理论的精准护理模式.比较两组患者术后肛门直肠功能、吻合口并发症发生率以及生活质量.结果 共纳入111例患者,其中试验组56例,对照组55例.试验组患者术后肛门直肠功能优良率显著优于对照组(69.64%vs.34.55%,P<0.05),试验组在生活质量功能领域的躯体形象、体重、焦虑、性欲以及症状领域的尿频、便频、腹胀等方面得分均优于对照组(P<0.05),但两组在术后吻合口并发症发生率上差异无统计学意义(3.57%vs.10.91%,P>0.05).结论 基于症状管理理论的精准护理模式可以有效恢复经括约肌间切除术后患者的肛门直肠功能,提升患者术后生活质量.

Abstract

Objective To explore the effects of precision care model for patients after intersphincteric resection based on symptom management theory.Methods Patients with intersphincteric resection in the colorectal and anal surgery department of Zhongnan Hospital of Wuhan University from June 2023 to March 2024 were prospectively selected by non-randomized concurrent controlled trail,and they were divided into the control group and the trial group according to the order of admission time.The control group received routine care,and the trial group received precision care model based on symptom management theory on the basis of the intervention in the control group.The anorectal function,anastomotic incidence and quality of life were compared between the two groups after intersphincteric resection.Results A total of 111 patients were enrolled in the study,with 56 in the trial group and 55 in the control group.The excellent rate of anorectal function in the trial group was significantly higher than that in the control group after surgery(69.64%vs.34.55%,P<0.05).The trial group scored better than the control group in the quality of life function domains of body image,weight,anxiety,and libido,and in the symptom domains of urinary frequency,frequency of defecation,abdominal distension and so on(P<0.05),but the difference between the two groups in the incidence of postoperative anastomotic complications was not statistically significant(3.57%vs.10.91%,P>0.05).Conclusion The precise care model based on symptom management theory can effectively restore the anorectal function of patients and improve the quality of life of patients after intersphincteric resection.

关键词

直肠癌/经括约肌间切除/吻合口/精准护理/症状管理理论

Key words

Rectal cancer/Intersphincteric resection/Anastomosis/Precision care/Symptom management theory

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基金项目

国家自然科学基金青年科学基金项目(82202915)

武汉大学中南医院护理学科培育项目(HLXKPY202101)

出版年

2024
医学新知
武汉大学中南医院,中国农工民主党湖北省委医药卫生工作委员会

医学新知

CSTPCD
影响因子:0.243
ISSN:1004-5511
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