张立娟 毕清泉

[摘要] 目的 探讨使用微信群的干预性措施在泌尿外科术后留置双J管患者延续护理中的应用效果。 方法 选择2016年6月～2017年5月安徽医科大学第四附属医院泌尿外科术后放置双J管并带管出院的90例患者，根据随机数字表法将其分为观察组（45例）和对照组（45例）。对照组患者给予常规宣教指导，观察组患者在对照组的基础上使用微信群延续护理。置管结束后，比较两组患者院外留置双J管期间并发症发生率、护理满意度的差异。 结果 观察组患者的并发症发生率明显低于对照组，差异有统计学意义（P < 0.05）；对留置双J管相关知识、并发症的预防及对策的掌握程度、对延续护理宣教方式的满意度和总分均高于对照组，差异有统计学意义（P < 0.05）。 结论 微信群的使用能显著减少泌尿外科术后留置双J管并发症的发生，提高患者对护理的满意度，提高护理的质量。

[关键词] 双J管；延续护理；术后；泌尿外科

[中图分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2018）04（a）-0165-04

[Abstract] Objective To explore the application effect of WeChat group in extended nursing in patients with Double J stents placement afer surgery. Methods From June 2016 to May 2017， in Department of Urology， Fourth Affiliated Hospital of Anhui Medical University， 90 patients with indwelling double J tube and discharged were selected， according to the random number table method， they were divided into observation group and control group， with 45 in each group. The control group received follow-up by regular health education and telephone， the observation group received extended care using WeChat group additionally. After the end of the catheter， the incidences of complications and self-care ability and satisfaction of patient were compared between two groups. Results The incidences of various complications and repetitive rate of nursing labor power in the observation group were significantly lower than those in the control group， the differences were statistically significant （P < 0.05）. In the observation group， the knowledge of the indwelling double J tube， the prevention of complications， the mastery of the countermeasures， the satisfaction degree and the total score of the continuing nursing education were higher than those in the control group， the differences were statistically significant （P < 0.05）. Conclusion The application of WeChat group for extended care in discharged patients with double J stents placement after surgery in Department of Urology can significantly reduced the incidence of complications and improve self-care ability and quality.

[Key words] Double J stents； Extended nursing； Postoperation； Department of Urology

雙J管在泌尿外科手术中应用广泛，适用于患肾结石、输尿管结石、肾及输尿管良性肿瘤、上尿路狭窄、上尿路手术以及体外碎石等患者的治疗，主要起到支撑、防止输尿管粘连和内引流作用[1]。作为异物植入体内，留置双J管患者一般需在术后1～3个月返回医院在膀胱镜下拔出[2]。但在留置期间，患者易产生血尿、尿路刺激症、膀胱区或腰区疼痛、双J管移位或脱落以及双J管遗忘等多种并发症[3]。因此，怎样通过有效的延续护理，能减少患者带管出院后，因生活环境的改变或护理中断引起相关并发症的发生，并且在保证护理质量的同时，又能提高患者满意度，一直是各类医院护理领域研究的热点和重要问题。延续护理是指为确保患者在不同健康照护场所（如从医院到家庭）以及同一健康照护场所不同部位之间转移时，为预防或减少患者健康状况的恶化，而形成的一系列连续性和协助性照护[4]。……