李茂玉 张玉芳 熊艳 高锦越 刘元媛

[摘要]目的：探讨护理路径在门诊小切口腋臭手术延续护理中的应用及效果。方法：以本院2017年1月-2017年10月门诊收治的行小切口腋臭手术患者153例为研究对象，按随机数表法分为对照组和观察组，对照组接受常规延续护理，观察组接受护理路径模式下的延续性护理，比较两组患者的临床依从性、并发症发生率及护理满意情况。结果：观察组患者依从性、并发症发生率及护理满意评分均明显优于对照组，差异有统计学意义（P<0.05）。结论：对门诊行小切口腋臭手术患者围手术期实施护理路径模式的延续护理可有效提高患者依从性，降低术后并发症发生率，提高患者护理满意度。

[关键词]护理路径；延续护理；门诊；腋臭

[中图分类号]R47 [文献标志码]B [文章编号]1008-6455（2018）04-0133-03

Application of Nursing Pathway in Continuous Nursing of Small Incision Osmidrosis Surgery in Outpatient Department

LI Mao-yu，ZHANG Yu-fang，XIONG Yan，GAO Jin-yue，LIU Yuan-yuan

（Department of Medical Cosmetology，Suining Central Hospital，Suining 629000，Sichuan，China）

Abstract： Objective To investigate the application and the corresponding effects of conducting nursing pathway for axillary osmidrosis outpatients with the incisions-treatment during perioperative period. Methods 153 patients who underwent small incision osmidrosis surgery in our hospital from January 2017 to October 2017 were selected as the research subject. All patients were randomly divided into the control group and the observation group. The control group received routine continuing care， and the observation group received continuous nursing under the nursing pathway. The clinical compliance， complications and nursing satisfaction of the two groups were compared. Results The compliance， complication rate and nursing satisfaction score of the observation group were significantly better than those of the control group， the difference were statistically significant（P<0.05）. Conclusion The application of nursing pathway for axillary osmidrosis outpatients with the incisions-treatment during perioperative period can effectively improve patient compliance， reduce the incidence of postoperative complications and improve the patient's nursing satisfaction.

Key words： nursing pathway； continuous nursing； outpatient service； axillary osmidrosis

相较于其他腋臭治疗手段，小切口腋臭大汗腺剪除术因其术后外观与根治效果优势明显，被认为是目前最优的治疗方法，但该术式出血量较多，有皮下血肿可能，有发生皮肤坏死、瘢痕形成等并发症风险[1]。其多在门诊局麻下完成，术后居家康复，家庭护理水平直接影响术后并发症的发生情况[2]。因此探讨科学有针对性的护理流程是目前护理工作者广泛讨论的问题[3-6]。本院于2011年开始通过电话随访的方式开展了延续护理，但执行过程中规范性、标准化等方面不尽如人意[7-8]，因家庭护理不当导致的术后并发症仍时有发生。临床护理路径是以对服务对象提供最优化照护为导向的先进护理模式，其采用简明方式将诊疗与护理工作标准化，可确保治疗和护理的连续性、规范化，让患者得到最佳服务[9-10]。本院于2017年开始将护理路径工作模式引入到门诊腋臭手术患者围手术期延续性护理中，以“循证医学”、“质量管理”、“患者为中心”，制订并实施了小切口腋臭门诊手术延续护理路径，效果良好，现报道如下。……