临床护理路径在镇痛镇静条件下超声消融子宫肌瘤中的应用(1)

http://www.100md.com 2017年4月2日 《医学信息》 2017年第13期

     摘要：目的 探讨临床护理路径在镇痛镇静条件下高强度聚焦超声消融(HIFU)子宫肌瘤中的应用效果。方法 将210例接受镇痛镇静条件下HIFU治疗子宫肌瘤患者随机分为对照组和观察组各105例，对照组实施常规护理方法，观察组采用临床护理路径进行护理，比较两组临床护理效果。結果 入院当天两组患者焦虑自评分(SAS)比较，差异无统计学意义(P>0.05)；出院当天观察组患者的SAS评分低于对照组，差异有统计学意义(P<0.05)。观察组患者围手术期不良反应发生率明显低于对照组，对健康知识的掌握率和护理满意度明显优于对照组，差异有统计学意义(P<0.05)。结论 对镇痛镇静条件下HIFU治疗子宫肌瘤患者应用临床护理路径实施全程护理，可改善患者焦虑情绪，降低不良反应的发生率，提高患者对健康知识的掌握率和护理满意度，提高临床护理质量，改善患者就医感受，促进医患和谐，值得临床推广应用。

    关键词：临床护理路径；高强度聚焦超声；子宫肌瘤

    中图分类号：R473.73 文献标识码：A 文章编号：1006-1959(2017)13-0054-03
, 百拇医药
    Abstract：Objective To investigate the clinical nursing path in ablation of high intensity focused ultrasound(HIFU)under the condition of analgesic and sedative effect in uterine leiomyoma.Methods 210 cases underwent HIFU treatment under sedation and analgesia in patients with uterine leiomyoma were randomly divided into control group and observation group of 105 cases，the control group implemented routine nursing method，the observation group used clinical nursing the path of nursing，clinical nursing effect was compared between the two groups.Results On the day of admission of two groups of patients with Self Rating Anxiety Scale (SAS)，the difference was not statistically significant(P>0.05)；on the day of discharge SAS scores of the observation group lower than in the control group，the difference was statistically significant(P<0.05).The observation group of patients with perioperative adverse reaction rate was significantly lower than the control group，the health knowledge rate and nursing satisfaction were significantly better than the control group，the difference was statistically significant(P<0.05).Conclusion The application of clinical nursing path in patients with uterine leiomyoma therapy on analgesia and sedation HIFU under the condition of the implementation of the whole nursing care can improve the anxiety of patients， reduce the incidence of adverse reactions and improve patients' health knowledge rate and nursing satisfaction，improve the quality of clinical care， improve patient feeling and promote harmony between doctors and patients，it is worthy of clinical application.
, http://www.100md.com
    Key words：Clinical nursing pathway；High intensity focused ultrasound；Uterine leiomyoma

    子宫肌瘤是一种妇科最为常见的良性肿瘤，以育龄期妇女为主要人群，发病率有关报道中证实在30%～40%[1]。目前主要采用手术治疗方法，包括子宫切除术和肌瘤剔除术，而肌瘤剔除术作为一种能保留子宫的生理功能以及身体的完整性的治疗方法，更能为患者所接受[2]，但无论是传统的开腹和腔镜微创子宫切除术对女性尤其育龄期女性，在生理、心理上均有较大影响。近年来，高强度聚焦超声消融(High intensity focused ultrasound，HIFU)技术已被多项研究及临床应用证实其作为一种新型的无创治疗技术，已经广泛应用于子宫肌瘤的治疗，通过超声消融子宫肌瘤，无需开刀，无需打孔，成功实现体外无创治疗，该技术在保证治疗效果的同时，又能保证患者子宫的完整性，且治疗时间短、恢复快，是治疗子宫肌瘤安全、有效的技术[3-4]。临床护理路径(clinical nursing pathway，CNP)又称临床程序，是为已确诊为某种疾病的一组患者制定的，以患者为中心，从入院到出院的一整套住院护理模式，是近年来发展起来的一种新型的、科学、高效的护理质量管理模式[5]。我院2016年将临床护理路径应用于HIFU治疗子宫肌瘤，取得了满意效果，现报告如下。, http://www.100md.com(宋晶彦 鞠进 侯海霞)

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