刘兰霞　张建荣　陈志锦

[摘要]目的 探讨移动宣教平台在行外科手术的血液透析患者中的应用效果。方法 选取2016年1月～2017年12月我院收治且行手术的透析患者107例。采用目的抽样法，将2016年1～12月收治且行手术的透析患者53例设为对照组，将2017年1～12月收治且行手术的透析患者54例设为观察组。观察组围术期采用血透专科护士基于微信平台构建的移动、便捷、可视宣教模式，对照组围术期采用常规外科护士面对面健康宣教模式，比较两组患者术前对预防手术部位感染认知情况、术后切口愈合情况、手术部位感染发生率。结果 观察组术前预防手术部位感染认知情况、术后切口愈合情况均优于对照组，差异有统计学意义（P<0.05），手术部位感染发生率低于对照组，差异有统计学意义（P<0.05）。结论 血透专科护士指导下的移动宣教平台能够对行外科手术的透析患者进行更为便捷有效的指导，提高患者预防手术部位感染认知，降低手术部位感染发生率。

[关键词]血液透析；移动宣教平台；外科；手术；感染

[中图分类号] R473.5 [文献标识码] A [文章编号] 1674-4721（2018）6（c）-0164-03

[Abstract]Objective To explore the application effect of mobile propaganda and education platform in hemodialysis patients performed with surgeries.Methods A total of 107 dialysis patients admitted to our hospital from January 2016 to December 2017 who underwent surgery were selected.Using objective sampling method，53 patients admitted from January to December 2016 were set as control group and 54 patients admitted from January to December 2017 were set as observation group.The observation group adopted a mobile，convenient and visual education model built by hemodialysis specialist nurses based on wechat platform during the perioperative period，while the control group adopted a face-to-face health education model for routine surgical nurses during the perioperative period.The preoperative awareness of the prevention of surgical site infection， postoperative wound healing， and the incidence of surgical site infection in the two groups were compared.Results The observation group was better than the control group in the cognition of prevention of surgical site infection before operation and the healing of incision after operation，and the difference was statistically significant （P<0.05）. The incidence of surgical site infection in the observation was lower than that of the control group， and the difference was statistically significant （P<0.05）.Conclusion The mobile propaganda and education platform under the guidance of professional nurses in the hemodialysis room can provide convenient and effective guidance for hemodialysis patients undergoing surgeries.It can improve patients′ knowledge of infection prevention in surgical sites and reduce the incidence of surgical site infection.

[Key words]Hemodialysis；Mobile propaganda and education platform；Department of Surgery；Operation；Infection

目前我國血液透析患者数量呈现逐年增长趋势[1-2]，行外科手术的血液透析患者数量也呈现增长趋势[3]；而行手术的血液透析患者与其他手术患者相比，更容易出现贫血、低蛋白血症、电解质紊乱等，这些因素使得血液透析患者手术部位感染发生率往往高于其他患者[4-5]。外科的医护由于不够专业，对透析期间行手术患者的宣教内容只关注本专业，而忽略强调与血液透析相关的围术期宣教。2017年1月开始我院在血液透析专科护士指导下，基于微信平台构建了移动、便捷、可视性宣教模式，对行外科手术的血液透析患者进行预防手术部位感染的相关知识宣教，以期降低手术部位感染发生率，现取得良好效果，现报道如下。