梁亚男　曹琴华　华迪

【摘要】 目的：探討综合护理干预在胸腔镜肺叶切除术中的应用效果。方法：选择2017年1月-2018年1月50例肺叶切除术患者，均在全身麻醉下行胸腔镜手术，随机分为研究组和对照组各25例。对照组实施手术室一般护理，研究组采用成立护理小组、综合评估、与病房护士的协同护理、术中个性化护理、快速康复外科护理等综合护理，记录两组术后6、12、24 h疼痛评分（VAS评分），观察两组护理满意度和舒适度，比较护理前后负性情绪（焦虑自评量表-SAS和抑郁自评量表-SDS）变化。结果：两组术后6 h时VAS评分比较差异无统计学意义（P>0.05），研究组术后12、24 h时VAS评分均低于对照组，差异均有统计学意义（P<0.05）。研究组护理满意度和舒适度评分均高于对照组，差异均有统计学意义（P<0.05）。护理前，两组SAS评分、SDS评分差异无统计学意义（P>0.05）；护理后，研究组SAS评分、SDS评分均低于对照组，差异均有统计学意义（P<0.05）。

结论：综合护理干预减轻胸腔镜肺叶切除术患者的术后疼痛，提高护理满意度和舒适度，改善负性情绪。

【关键词】 综合护理干预； 胸腔镜； 肺叶切除术； 效果

doi：10.14033/j.cnki.cfmr.2018.24.028 文献标识码 B 文章编号 1674-6805（2018）24-00-03

Effect of Comprehensive Nursing Intervention on Patients with Thoracoscopic Lobectomy/LIANG Yanan，CAO Qinhua，HUA Di.//Chinese and Foreign Medical Research，2018，16（24）：-60

【Abstract】 Objective：To investigate the effect of comprehensive nursing intervention on patients with thoracoscopic lobectomy.Method：A total of 50 patients with pulmonary lobectomy were selected from January 2017 to January 2018.All patients underwent thoracoscopic surgery under general anesthesia and were randomly divided into study group and control group （25 cases in each group）.The patients in the control group were given general nursing care in the operating room，while in the study group，the nursing group was set up，the comprehensive evaluation，the cooperative nursing with the nurses in the ward，the individualized nursing during the operation，the nursing of the rapid rehabilitation surgery，and so on.The VAS scores at postoperative 6，12 and 24 h were recorded，the nursing satisfaction and comfort were observed，and the negative emotion （self rating anxiety scale -SAS and self rating depression scale -SDS） were compared in the two groups.Result：There was no significant difference in VAS scores at postoperative 6 h in the two groups （P>0.05），The VAS scores at postoperative 12 h and 24 h in the study group were lower than those in the control group（P<0.05）.The nursing satisfaction and comfort scores in the study group were higher than those in the control group（P<0.05）.Before nursing，there were no significant difference in SAS scores and SDS scores in the two groups （P>0.05），after nursing，the SAS scores and SDS scores in the study group were lower than those in the control group（P<0.05）.Conclusion：Comprehensive nursing intervention could relieve postoperative pain，improve nursing satisfaction and comfort and improve negative emotions in patients undergoing thoracoscopic lobectomy.

【Key words】 Comprehensive nursing intervention； Thoracoscopic lobectomy； Effect

First-authors address：Jiangyin Hospital Affiliated to Southeast University Medical College，Jiangyin 214400，China

胸腔镜肺叶切除术是治疗肺癌、肺大泡及肺结节等的有效手术方式，具有微创、美观、术中出血少、术后恢复快等优点，但术后疼痛、护理满意度及负性情绪等仍是护理人员关注的重点[1]。随着社会进步和护理模式发展，护理干预的目的不仅是躯体疾病的康复，而且更加关注患者身心健康的发展。研究显示，护理干预在胸腔镜肺叶切除术患者的围术期治疗中占有重要地位，可提高手术疗效[2]，减轻术后疼痛，提高护理满意度等[3]。综合护理干预是临床护理工作的重要内容，主要是以患者为中心，从躯体、心理、社会等多方面进行护理，促使患者身心快速康复[4]。本……