申晓芬?李黎?周振宇?韦小兰?刘春淋?方小丽?杨庆娟?陈金华

[摘要] 目的 比较传统护理模式与应用临床护理路径对永久起搏器植入患者术后护理效果及生活质量的影响。方法 设置患者一般情况调查表、起搏器患者护理需求调查表、焦虑量表、临床护理路径表。将120例永久起搏器置入患者随机分为实验组和对照组，每组各60例。实验组采用临床护理路径管理，对照组进行常规护理干预，观察并比较两组患者术后护理需求、并发症的发生、焦虑状况、住院天数和住院费用等情况。 结果 与对照组比较，实验组术后并发症发生率、汉密尔顿焦虑量表评分、住院天数和住院费用均显著降低（P<0.01）；患者满意度显著提升（P<0.01）。 结论 实施临床护理路径管理更能有效满足患者术后的护理需求，显著减少患者术后并发症的发生、减轻患者住院经济负担，显著提升患者满意度。

[关键词] 起搏器；临床护理路径；护理需求；焦虑；效果

[中图分类号] R473.6 [文献标识码] A [文章编号] 2095-0616（2017）16-106-04

Effect of clinical nursing pathway on patients with permanent artificial cardiac pacemaker implantation

SHEN Xiaofen LI li ZHOU Zhenyu WEI Xiaolan LIU Chunlin FANG Xiaoli YANG Qingjuan CHEN Jinhua

Department of Cardiology，the Central Hospital of Nanchong，the Second Clinical School of North Sichuan Medical College，Nanchong 637000，China

[Abstract] Objective To compare the nursing effects on the patients with permanent pacemaker implantation between the conventional nursing methods and the clinical nursing pathway. Methods The general questionnaire，pacemaker patient care-need questionnaire，anxiety scale and the clinical nursing pathway table were made.120 patients with permanent pacemaker implantation were randomly divided into experimental group and control group，60 in each group.Patients in experimental group were intervened with the clinical nursing pathway.Patients in control group were received the routine nursing intervention，the care-needs，the incidence rate of the complications，the anxiety score，the length of stay and the hospitalization expense of the two groups of were analyzed. Results Compared with the control group，the incidence of postoperative complications，Hamilton Anxiety Scale score，hospitalization days and hospitalization expenses in the experimental group were significantly lower （P<0.01）.The satisfaction degree of patients increased significantly （P<0.05）. Conclution Implementation of clinical nursing pathway management can further meet the nursing-demand of patients，reduce the complications，decrease the economic burden for patients，and improve the patient satisfaction.

[Key words] Pacemaker；Clinical nursing path；Care needs；Anxiety；Effects

安置永久性人工心臟起搏器是治疗缓慢心律失常、房室传导阻滞、心力衰竭等心脏疾病的一种安全、有效的重要手段[1]。我国从2002～2012年人工心脏起搏器置入总数，年平均增长在12%左右，保持较强的增长趋势[2]。永久性人工心脏起搏器植入术具有一定的创伤性和风险性，容易使患者产生焦虑、恐惧等负性情绪。有文献报道，永久性人工心脏起搏器植入术后，患者生活行为方式、安全防护意识以及自我随访管理与其生活质量和并发症密切相关[3-4]。在现代生物-心理-社会医学模式下，永久性人工心脏起搏器植入术后患者的健康需求和不良情绪的产生越来越受到人们的关注[5-6]。临床护理路径是针对患有某种疾病的患者的监测、治疗、康复和护理所制定的一个有严格的工作程序、时间要求的照顾计划，以减少康复的延迟及资源的浪费，使服务对象获得最佳的医疗护理服务质量[7]。……