医护延伸服务改善胃食管反流患者依从性和预后(1)
[摘要] 目的 探讨将医护服务延伸，改善近端胃切除术后胃食管反流患者出院后的预后。 方法 选取我院2017年1～9月实施延伸医护服务后连续接治的50例近端胃切除术后胃食管反流患者为试验组，按照1：1选取2016年2～12月前未实施延伸医护服务时连续接治的50例同类患者为对照组。试验组患者给予医护延伸服务，对照组患者为常规指导。应用依从性调查问卷、反流体征和症状量表调查患者出院后1个月、3个月的依从性和反流症状体征变化，整理数据并分析。 结果 出院后1个月、3个月，试验组依从性得分分别为(26.20±2.80)分、(24.62±3.38)分，对照组相应得分为(19.52±3.48)分、(16.60±3.40)分，试验组得分显著高于对照组，差异有统计学意义(P<0.01);试管组与对照组出院后3个月反流体征得分分别为(2.56±0.67)分、(3.89±1.11)分，反流症状得分分别为(3.65±0.86)分和(5.32±1.68)分，试验组得分均显著低于对照组，差异有统计学意义(P<0.001)。 结论 医护延伸服务可满足近端胃切除术后食道反流患者出院后对医护的需求，有效提高出院后的依从性，改善预后。
[关键词] 医护延伸服务;近端胃切除;胃食管反流;预后
[中图分类号] R473.5 [文献标识码] B [文章編号] 1673-9701(2019)28-0161-04
[Abstract] Objective To explore the extension of medical services in improving the prognosis of patients with gastroesophageal reflux after proximal gastrectomy. Methods A total of 50 patients with gastroesophageal reflux after proximal gastrectomy who were treated with medical extension service in our hospital from January to September 2017 were enrolled as the experimental group. The 50 similar patients who were not continuously treated with medical extension service from February to December 2016 were selected according to 1：1. Patients in the experimental group were given medical extension service， and patients in the control group were routinely guided. The compliance questionnaire， the reflux signs and the symptom scale were used to investigate the changes of compliance and signs of reflux symptoms and signs at 1 month and 3 months after discharge from the hospital， and the data were analyzed. Results At 1 month and 3 months after discharge， the compliance scores of the experimental group were(26.20±2.80) and (24.62±3.38)， respectively. The corresponding scores of the control group were(19.52±3.48) and(16.60±3.40). The scores of experimental group were significantly higher than those of the control group， and the differences were statistically significant (P<0.01). At 3 months after discharge， the scores of the reflux signs were (2.56±0.67)， (3.89±1.11)， and the scores of reflux symptoms were (3.65±0.86) and (5.32±1.68) points in the experimental group and control group. The scores of experimental group were significantly higher than those of the control group， and the differences were statistically significant(P<0.001). Conclusion The medical extension service can meet the need for medical nursing after discharge from the hospital of patients with esophageal reflux after proximal gastrectomy， and effectively improve post-discharge compliance and improve prognosis., http://www.100md.com(黄书彬 金益曼 张若 Arvine Chandoo 徐晓武 纪伟平)
[关键词] 医护延伸服务;近端胃切除;胃食管反流;预后
[中图分类号] R473.5 [文献标识码] B [文章編号] 1673-9701(2019)28-0161-04
[Abstract] Objective To explore the extension of medical services in improving the prognosis of patients with gastroesophageal reflux after proximal gastrectomy. Methods A total of 50 patients with gastroesophageal reflux after proximal gastrectomy who were treated with medical extension service in our hospital from January to September 2017 were enrolled as the experimental group. The 50 similar patients who were not continuously treated with medical extension service from February to December 2016 were selected according to 1：1. Patients in the experimental group were given medical extension service， and patients in the control group were routinely guided. The compliance questionnaire， the reflux signs and the symptom scale were used to investigate the changes of compliance and signs of reflux symptoms and signs at 1 month and 3 months after discharge from the hospital， and the data were analyzed. Results At 1 month and 3 months after discharge， the compliance scores of the experimental group were(26.20±2.80) and (24.62±3.38)， respectively. The corresponding scores of the control group were(19.52±3.48) and(16.60±3.40). The scores of experimental group were significantly higher than those of the control group， and the differences were statistically significant (P<0.01). At 3 months after discharge， the scores of the reflux signs were (2.56±0.67)， (3.89±1.11)， and the scores of reflux symptoms were (3.65±0.86) and (5.32±1.68) points in the experimental group and control group. The scores of experimental group were significantly higher than those of the control group， and the differences were statistically significant(P<0.001). Conclusion The medical extension service can meet the need for medical nursing after discharge from the hospital of patients with esophageal reflux after proximal gastrectomy， and effectively improve post-discharge compliance and improve prognosis., http://www.100md.com(黄书彬 金益曼 张若 Arvine Chandoo 徐晓武 纪伟平)