屈娟娟 骆秀琴 缪殷姝

摘要：目的  探讨对重症肌无力患者应用细节护理的效果，评估其对改善患者病情的作用。方法  选取2016年1月～2018年1月于我院治疗的64例重症肌无力患者，随机分为观察组和对照组，各32例。对照组采用常规护理，观察组采用细节护理，比较两组治疗后病情改善程度、并发症发生率及护理满意度。结果  观察组并发症发生率为9.38%，低于对照组的28.13%，差异具有统计学意义（P<0.05）;观察组身体疼痛、生理机能、精神状态和一般健康评分均高于对照组，差异具有统计学意义（P<0.05）;观察组护理满意度为90.63%，高于对照组的65.63%，差异具有统计学意义（P<0.05）。结论  细节护理在重症肌无力患者中具有一定的积极意义，能有效预防并发症，促进患者病情改善，患者护理满意度高，应该效果好。

关键词：细节护理;重症肌无力;健康状况;并发症

Abstract：Objective  To explore the effect of applying detailed nursing to patients with myasthenia gravis， and to evaluate its effect on improving patients' condition.Methods  64 patients with myasthenia gravis treated in our hospital from January 2016 to January 2018 were randomly divided into observation group and control group， 32 cases each. The control group received routine nursing， and the observation group received detailed nursing， comparing the improvement of the two groups after treatment， the incidence of complications and nursing satisfaction.Results  The incidence rate of complications in the observation group was 9.38%， which was lower than that in the control group 28.13%，the difference was statistically significant （P<0.05）.The physical pain， physiological function， mental state and general health score of the observation group were higher than the control group， the difference was statistically significant （P<0.05）; the nursing satisfaction of the observation group was 90.63%， higher than the control group 65.63%， the difference was statistically significant （P<0.05）.Conclusion  Detailed nursing has certain positive significance in patients with myasthenia gravis. It can effectively prevent complications and promote the improvement of the patient's condition. The patient's nursing satisfaction is high and should be effective.

Key words：Detailednursing;Myasthenia gravis;Health condition;Complications

重症肌无力（myasthenia gravis）是以神经肌肉乙酰胆碱传递受阻为主要病因的一种疾病，此病会引起身体机能发生免疫性的慢性病变[1]，出现身体局部肌肉或全身活动无力，易疲乏，特别是在晚上加重[2]。一般需要服用抗胆碱酯酶的药物进行治疗，症状会有所改善，但就目前来看此病依旧会引发生命危象的严重疾病。由于长期身体无力，病情易反复且患病时间长，特别是重症肌无力会产生呼吸肌无力，使患者出现呼吸障碍，极度的“濒死感”会进一步加剧患者的恐慌心理，给患者的生活和心理造成很大负担，会使患者产生焦虑和沮丧感，失去生活的希望和治疗的信心[3，4]。然而此病若消极对待、不积极治疗，会导致患者出现呼吸道感染、便血、腹痛、褥疮等一系列并发症，甚至窒息或死亡，因此重症肌无力患者应及时就医、积极控制病情[6]。研究报道，细节护理可有效缓解患者的焦虑情绪，帮助患者在舒适、平稳的心理状态下接受治疗，同时还可以帮助患者有效改善临床症状，预防并减少并发症，对该病的治疗具有一定的积极作用。……