侯秒 单淑珍

[摘要]目的 探讨舒适护理在肛肠外科术后肛周护理中的作用。方法 回顾性分析2018年1月～2019年6月我院诊治的118例肛肠外科术患者的临床资料，按照护理模式不同将其分为对照组和研究组，每组各59例。对照组采取常规护理模式，研究组采取舒适护理模式，比较两组术后48 h内不同时间点的疼痛程度、护理前后睡眠质量及心理状态。结果 研究组术后4、12、24、48 h疼痛评分低于对照组（P<0.05），且两组术后12、24、48 h疼痛评分低于术后4 h（P<0.05）;研究组护理后的Ⅲ兹堡睡眠质量指数问卷（PSQI）、90项精神症状自评量表（SCL-90）评分低于对照组（P<0.05），且两组护理后PSQI、SCL-90评分低于护理前（P<0.05）。结论 舒适护理在肛肠外科术后肛周护理中优势明显，可有效镇痛，改善患者术后心理状态，提高睡眠质量水平。

[关键词]舒适护理;肛肠外科术;肛周护理;睡眠质量;疼痛

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-4721（2020）7（c）-0235-03

Application effect of comfort nursing in perianal nursing after anorectal surgery

HOU Miao   SHAN Shu-zhen

Department of Anorectal， Xinhua Hospital Affiliated to Dalian University， Liaoning Province， Dalian   116021， China

[Abstract] Objective To explore the application effect of comfort nursing in perianal nursing after anorectal surgery. Methods The clinical data of 118 patients undergoing anorectal surgeries treated in our hospital from January 2018 to June 2019 were retrospectively analyzed. They were divided into the control group and the study group according to different nursing models， 59 cases in each group. In the control group was adopted conventional nursing， and in the study group comfort nursing was used. The pain degrees at different time points， sleep quality before and after nursing， and changes in mental state 48 h after surgery were compared. Results The pain scores of patients in the study group at 4， 12， 24， and 48 h after surgery were lower than those in the control group （P<0.05）. The pain scores at 12， 24， and 48 h after surgery in the two groups were all lower than 4 hours after surgery （P<0.05）. Meanwhile， the Pitsburgh sleep quality index questionnaire （PSQI） and 90 item self-rating scale for mental symptoms （SCL-90） score of the study group after nursing were also lower compared with that in the control group （（P<0.05））. The PSQI and SCL-90 score in the two groups after nursing were lower than those before nursing （P<0.05）. Conclusion Comfort nursing has obvious advantages in perianal care after anorectal surgery. It can effectively relieve pain， and improve postoperative psychological status and sleep quality.

[Key words] Comfort nursing; Anorectal surgery; Perianal care; Sleep quality; Pain

據报道[1]，肛肠外科术后普遍存在肛周并发症，如肛瘘、肛周脓肿等，尤其是肛周脓肿，发生率较高，且伴发剧烈疼痛，影响患者睡眠、心理状态，造成严重不适，要求提供舒适护理干预。舒适护理模式为国内医疗护理模式转变成果之一，要求体现“以人为本”的医疗护理观念，从患者角度出发，考虑其在治疗和护理期各方面不适感和护理需求，提出相应解决对策，以减轻其心理和生理方面不适感。舒适护理应用频率较高，近几年来在各种疾病护理均使用，其可行性、优越性已经验证，因而认为可尝试在肛周护理中应用舒适护理干预，但该护理模式能否解决肛肠外科术后肛周问题，能否为解除患者心理、生理方面的不适感，尚未可知。为证明上述猜想的科学性，现开展本分组对照试验，即从患者术后不同时间点疼痛程度、睡眠质量与心理状态着手，对应用不同护理方案的两组肛肠外科术后肛周脓肿患者临床资料进行回顾性分析，现报道如下。……