体位管理在行胃内镜黏膜下剥离术患者中的应用-现代医学

体位管理在行胃内镜黏膜下剥离术患者中的应用

单位：南京医科大学第一附属医院消化内科, 江苏南京 210029

分类号：R473.5

出版年·卷·期（页码）：2022·50·第七期（901-904）

摘要：

目的：探讨体位管理在行胃内镜黏膜下剥离术（endoscopic submucosal dissection，ESD）患者中的应用效果。方法：选取2019年5月至2020年6月本院消化内科收治的292例因胃病变行ESD患者为研究对象，采用随机数字表法将其分为对照组和干预组，其中对照组150例，干预组142例。对照组予常规护理，术后协助患者取舒适卧位；干预组在常规护理基础上，根据其病变手术解剖部位采取不同的体位。比较两组患者术后出血发生率、穿孔发生率、住院费用、住院时间、疼痛评分、舒适度得分及对护理工作满意度等指标的差异。结果：两组均无患者发生术后穿孔。干预组患者术后出血发生率，住院费用，住院时间，术后第1、2天疼痛评分均低于对照组，舒适度得分及对护理工作的满意度优于对照组，两组间差异均有统计学意义（P<0.05）。结论：针对性体位管理可有效降低行ESD患者术后出血发生率，减少住院时间和住院费用，减轻疼痛症状，提高患者舒适度及对护理工作的满意度。

Objectives: To explore the application effect of postural management in patients undergoing gastric endoscopic submucosal dissection(ESD). Methods: From May 2019 to June 2020, 292 Patients underwent gastric ESD in our hospital were randomly divided into control group and observation group, 150 patients were divided into the control group, and 142 patients in the intervention group. The patients in the control group were nursed according to the ESD routine in our hospital, and they were assisted to comfortable position after operation. On the basis of routine nursing, patients in the intervention group underwent postural management according to the different pathological positions after operation. Finally, the incidence of postoperative bleeding, perforation, hospitalization expenses and time, pain scores, comfort scores and satisfaction of nursing work were compared between the two groups after ESD. Results: None of the patients in this study experienced perforation. The patients in the intervention group presented with lower incidence of postoperative bleeding, hospitalization expenses, hospital stay and pain scores. The intervention group presented with higher comfort scores and satisfaction toward nursing compared with patients in the control group. Conclusions: Targeted postural management in patients undergoing gastric ESD effectively reduces the incidence of postoperative bleeding, hospitalization expenses and time, lower pain scores, improve the comfort scores and the satisfaction toward nursing.

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