姚映笑 吴玉轩 谢桂兰

[摘要]目的 探討强化自我护理干预用于支撑喉镜下声带息肉切除术后患者的效果。方法 选取2018年2月～2019年6月东莞市企石医院收治的62例行支撑喉镜下声带息肉切除患者，按照随机数字表法分为两组，每组各31例。对照组给予常规护理，研究组给予强化自我护理干预。比较两组入院时、3个月时自我护理能力及术后1、3个月时嗓音功能恢复情况。结果 两组入院时自我护理能力测试表中自我护理技能、自我护理知识、自我概念、自我护理责任感维度评分比较，差异无统计学意义（P>0.05）;术后3个月时两组自我护理能力测试表中自我护理技能、自我护理知识、自我概念、自我护理责任感维度评分均高于入院时，差异有统计学意义（P<0.05）。研究组自我护理能力测试表中自我护理技能、自我护理知识、自我概念、自我护理责任感维度评分高于对照组，差异有统计学意义（P<0.05）。研究组术后1个月嗓音功能恢复良好率高于对照组，差异有统计学意义（P<0.05），两组术后3个月时嗓音功能恢复良好率比较，差异无统计学意义（P>0.05）。结论 强化自我护理干预应用于支撑喉镜下声带息肉切除术后患者可提高患者自我护理能力，促进术后嗓音功能恢复。

[关键词]支撑喉镜下声带息肉切除术;强化自我护理干预;自我护理能力;嗓音功能

[中图分类号] R473.76          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0211-04

Application effect of intensive self-care intervention in patients with vocal cord polypectomy under laryngoscope

YAO Ying-xiao1   WU Yu-xuan1   XIE Gui-lan2

1. Department of ENT and Urology， Dongguan Qishi Hospital， Guangdong Province， Dongguan   523500， China; 2. Department of ENT， Dongguan Hospital of Traditional Chinese Medicine， Guangdong Province， Dongguan   523500， China

[Abstract] Objective To explore the application effect of strengthening self-care intervention in patients with vocal cord polypectomy under laryngoscope. Methods From February 2018 to June 2019， 62 patients with vocal cord polypectomy under laryngoscope treated in Dongguan Qishi Hospital were selected and divided into two groups according to random number table method， 31 cases in each group. The control group was given routine care， the study group was given intensive self-care intervention. The ability of self-care at admission and 3 months and the recovery of voice function at 1 and 3 months after operation were compared between the two groups. Results There were no significant differences in the scores of self-care skills， self-care knowledge， self-concept and self-care responsibility between the two groups （P>0.05）. The scores of self-care skills， self-care knowledge， self-concept and self-care responsibility in the self-care ability test table of the two groups at 3 months after operation were higher than those， the differences were statistically significant （P<0.05）. The scores of self-care skills， self-care knowledge， self-concept and self-care responsibility in the test table of self-care ability in the study group were higher than those in the control group， the differences were statistically significant （P<0.05）. The recovery rate of voice function in the study group was higher than that in the control group at 1 month after operation， the difference was statistically significant （P<0.05）. Comparison of the recovery rate of voice function between the two groups at 3 months after operation showed no statistically significant difference （P>0.05）. Conclusion Strengthening self-care intervention in patients with vocal polypectomy under laryngoscope can improve their self-care ability and promote the recovery of voice function.

行支撑喉镜下声带息肉切除术患者自我护理能力越高，术后嗓音功能恢复越好。研究组术后1个月嗓音功能恢复良好率高于对照组，差异有统计学意义（P<0.05）。提示强化自我护理干预可促进嗓音功能恢复。分析原因是：①加强对患者心理干预，提高对患者家庭社会支持，减轻患者不良情绪。患者心态越好越会遵从医嘱康复训练[13]，越有利于嗓音功能恢复。②通过多种方式给予患者科学嗓音恢复训练指导和监督，不断督促患者嗓音恢复训练[14]，提高康复速度。本研究与冯雷等[15]研究结果一致，提示强化自我护理干预有利于患者术后嗓音功能恢复。两组术后3个月时嗓音功能恢复良好率比较，差异无统计学意义（P>0.05）。分析原因是因为术后3个月时两组嗓音功能均差不多恢复，所以两组嗓音功能恢复良好率相似。

但在临床中要针对患者不同情况及康复程度采取针对性护理方案，要加强对护理人员专业培训，在此后研究中增加样本量同时加入远期恢复效果及复发情况内容评价，以便更好了解患者恢复情况，而不断调整护理内容，向患者提供更加优质护理服务。