摘要
目的:探究失效模式与效应分析下质控干预联合应激反应专项护理对胃肠手术患者的影响。方法:选取2020年2月—2021年10月于湖北省中医院就诊的86例胃肠手术患者,按照随机扔骰子法将其分为联合组和对照组,各43例。对照组采取应激反应专项护理,联合组在对照组的基础上采用失效模式与效应分析下质控干预护理。比较两组手术相关指标(肠鸣音恢复时间、首次排气时间、进食时间、下床活动时间、住院时间),比较两组干预前及干预1 d、3 d、5 d后的疼痛数字评分法(NRS)评分和空腹血糖(FPG)水平,采用心理弹性量表(ER89)评估患者心理应激能力,比较两组术后并发症(切口感染、腹胀、粘连性肠梗阻)发生率及护理满意程度。结果:联合组肠鸣音恢复时间、首次排气时间、进食时间、下床活动时间均早于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。干预1 d、3 d、5 d后,两组的NRS评分和FPG均优于干预前,差异有统计学意义(P<0.05);干预前和干预1 d后,两组的NRS评分和FPG比较,差异无统计学意义(P>0.05),干预3 d、5 d后,联合组NRS评分低于对照组,FPG的波动幅度均小于对照组,差异有统计学意义(P<0.05)。干预前,两组ER89评分比较,差异无统计学意义(P>0.05),干预后,两组ER89评分均高于干预前,且联合组显著高于对照组,差异有统计学意义(P<0.05)。联合组切口感染、腹胀及粘连性肠梗阻发生率均低于对照组,但组间比较,差异无统计学意义(P>0.05)。联合组干预后护理满意度评分显著高于对照组,差异有统计学意义(P<0.05)。结论:失效模式与效应分析下质控干预联合应激反应专项护理可有效减少胃肠手术患者恢复时间和应激反应,并有效增加其心理应激能力,有利于患者恢复。
Objective:To explore the effect of quality control intervention under failure mode and effect analysis combined with stress response special nursing on gastrointestinal surgery patients.Method:A total of 86 patients with gastrointestinal surgery from February 2020 to October 2021 in Hubei Provincial Hospital of Traditional Chinese Medicine were randomly divided into the combined group and the control group according to the dice throwing method,with 43 cases in each group.The control group was given stress response special nursing,and the combined group was given quality control intervention under failure mode and effect analysis on the basis of the control group.The operation-related indicators(bowel sound recovery time,first exhaust time,time to eat,time to get out of bed,and time to stay in hospital)of the two groups were compared,the numeric rating scale(NRS)and fasting plasma glucose(FPG)level of the two groups before intervention and after 1 d,3 d and 5 d of intervention were compered,and the psychological stress ability of patients with the ego resilience 89 scale(ER89)was evaluated,the incidence of postoperative complications(incision infection,abdominal distension,adhesive intestinal obstruction)and the degree of nursing satisfaction were compared between the two groups.Result:The recovery time of bowel sounds,the time of first exhaust,the time of eating and the time of getting out of bed in the combined group were earlier than those in the control group,and the time of hospitalization was shorter than that in the control group,the differences were statistically significant(P<0.05).After 1 d,3 d and 5 d of intervention,the NRS scores and FPG of the two groups were better than those before intervention,the differences were statistically significant(P<0.05).There were no significant differences in NRS scores and FPG between the two groups before and 1 d after intervention(P>0.05).After 3 d and 5 d of intervention,the NRS scores of the combined group were lower than those of the control group,and the fluctuation range of FPG were less than those of the control group,the differences were statistically significant(P<0.05).Before intervention,there was no significant difference in ER89 scores between the two groups(P>0.05).After intervention,the ER89 scores of the two groups were higher than those before the intervention,and the combined group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).The incidence of incision infection,abdominal distension and adhesive intestinal obstruction in the combined group were lower than those in the control group,but there were no significant difference between the two groups(P>0.05).The nursing satisfaction score of the combined group was significantly higher than that of the control group,the differences was statistically significant(P<0.05).Conclusion:Quality control intervention nursing under failure mode and effect analysis combined with stress response special nursing can effectively reduce the recovery time and stress response of gastrointestinal surgery patients,and effectively increase their psychological stress ability,which is conducive to the recovery of patients.
作者
梁行
潘晟
LIANG Xing;PAN Sheng(Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430074,China;不详)
出处
《中外医学研究》
2023年第9期78-82,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
湖北省卫生健康委员会联合基金项目(WJ2019H225)。
关键词
失效模式与效应分析
质控干预
应激反应
胃肠手术
满意度
心理应激
Failure mode and effect analysis
Quality control intervention
Stress response
Gastrointestinal surgery
Satisfaction
Psychological stress
