中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

PDCA 循环管理措施对胸主动脉瘤患者围术期的疼痛、心理及预后的影响

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目的 探讨 PDCA 循环管理措施对胸主动脉瘤患者围术期的疼痛、心理及预后的影响。 方法 回顾性分析 2016 年 4 月至 2017 年 3 月采用 PDCA 循环管理措施进行围术期护理的 76 例胸主动脉瘤患者的临床资料,并将其作为研究组,其中男 44 例、女 32 例,23~65(47.27±5.87)岁。同时选取 2015 年 4 月至 2016 年 3 月采用常规护理模式进行围术期护理的 72 例胸主动脉瘤患者为对照组,其中男 41 例、女 31 例,年龄 24~67(48.30±5.26)。对比分析两组患者的疼痛、心理及预后情况。 结果 研究组手术时间(t=11.342,P<0.05)和住院时间(t=5.986,P<0.05)均明显短于对照组。两组患者护理前的视觉模拟评分(VAS)差异无统计学意义(t=0.914,P=0.361);护理后,研究组 VAS 评分明显低于对照组(t=5.475,P<0.05)。两组患者护理前抑郁自评表(SDS)评分(t=1.026,P=0.307)和焦虑自评表(SAS)评分(t=0.422,P=0.674)比较无显著差异;护理后,研究组 SDS(t=7.657,P<0.05)和 SAS 评分(t=7.866,P<0.05)明显低于对照组。研究组不良反应发生率明显低于对照组(χ2=4.292,P=0.038)。 结论 PDCA 循环护理管理模式用于胸主动脉瘤患者围术期护理,能够有效缓解患者疼痛及抑郁焦虑情况,降低不良反应发生率,预后良好。

Objective To investigate the effect of PDCA circulation management measures on pain, psychology and prognosis of patients with thoracic aortic aneurysm in the perioperative period. Methods Seventy-six patients of patients with thoracic aortic aneurysm who received perioperative nursing based on PDCA circular management from April 2016 to March 2017 were retrospective analyzed and selected to study group, including 44 males, 32 females, aged of 23–65 (47.27±5.87) years. At the same time, 72 patients of patients with thoracic aortic aneurysm who received perioperative routine nursing from April 2015 to March 2016 were selected to control group, including 41males, 31 females, aged 24–67 (48.30±5.26) years. The nursing effects of the two groups were compared and analyzed. Results The operation time (t=11.342, P<0.05) and hospitalization time (t=5.986, P<0.05) of the study group were significantly shorter than those of the control group. The visual analogue scale (VAS) scores of the two groups had no significant difference before nursing (t=0.914, P=0.361), the VAS scores in the study group after nursing were obviously lower than that in the control group (t=5.475, P<0.05). The depression self-assessment (SDS) (t=1.026, P=0.307) and anxiety self-assessment (SAS) scores (t=7.866, P<0.05) of the two groups had no significant difference before nursing, while the SDS (t=7.657, P<0.05) and SAS (t=7.866, P<0.05) scores in the study group after nursing were obviously lower than those in the control group. The incidence of adverse reactions in the study group was significantly lower than that in the control group (χ2=4.292, P=0.038). Conclusion PDCA circulation management measures are used in patients with thoracic aortic aneurysm in the perioperative period, which can effectively relieve patients' pain and depression anxiety, reduce the incidence of adverse reactions, and the prognosis is good.

关键词: 胸主动脉瘤; PDCA 循环; 护理; 心理状况; 疼痛

Key words: Thoracic aortic aneurysm; PDCA circulation; nursing; psychologic status; pain

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