侯秒 蒋励

[摘要]目的 探讨循证护理在肛肠手术患者护理中的应用效果。方法 选取2018年9月～2019年9月我院收治的100例肛肠手术患者作为研究对象，按照奇偶数将其分成两组。对照组（n=50）开展常规护理，而研究组（n=50）实施循证护理，记录两组的肛门排气时间、肠鸣音恢复时间、首次排便时间及住院时间相关恢复指标，计算最大尿流率和膀胱残余尿量等排尿指标，用自制满意度调查表比较患者对护理的满意度。结果 研究组的肛门排气时间、肠鸣音恢复时间、首次排便时间及住院时间短于对照组，差异均有统计学意义（P<0.05）。研究组干预后膀胱残余尿量为（48.67±23.11）ml，少于对照组的（79.86±24.38）ml，差异有统计学意义（P<0.05）。研究组干预后最大尿流率为（14.36±4.34）ml/s，大于对照组的（12.65±4.12）ml/s，差异有统计学意义（P<0.05）。研究组护理总满意度为96.00%，高于对照组（82.00%），差异有统计學意义（χ2=5.005，P<0.05）。结论 对肛肠手术实施循证护理干预，能缩短治疗时间，促进患者术后恢复，对预防排尿障碍有积极意义，值得在临床推广和应用。

[关键词]循证护理;肛肠手术;排尿障碍;肛门排气时间;膀胱残余尿量;最大尿流率

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-4721（2020）7（a）-0231-03

Application effect of evidence-based nursing in patients undergoing anorectal operation

HOU Miao   JIANG Li▲

Department of Anus and Intestine， Xinhua Hospital Affiliated to Dalian University， Liaoning Province， Dalian  116021， China

[Abstract] Objective To probe into the application effect of evidence-based nursing in anorectal operation. Methods A total of 100 patients with anorectal surgery from September 2018 to September 2019 in our hospital were selected and divided into two groups according to the pattern of odd and even numbers. The control group （n=50） carried out routine nursing， while the study group （n=50） carried out evidence-based nursing， and recorded the recovery indexes such as anal exhaust time， bowel sound recovery time， first defecation time and hospitalization time， the maximal urinary flow rate （MRF） and bladder residual urine volume （BPH） were calculated， and the patients′ satisfaction with nursing was evaluated by self-designed satisfaction questionnaire. Results The anal exhaust time， bowel sounds recovery time， first defecation time and hospital stay time in the study group were shorter than those in the control group， with statistical differences （P<0.05）. The residual urine volume of bladder in the study group was （48.67±23.11） ml， which was less than that in the control group of （79.86±24.38） ml， with statistical difference （P<0.05）. The maximal urinary flow rate was （14.36±4.34） ml/s in the study group， which was higher than that in the control group of （12.65±4.12） ml/s， with statistical difference （P<0.05）. The nursing total satisfaction of the patients in the study group was 96.00%， higher than that of the control group （82.00%）， with statistical difference （P<0.05）. Conclusion Evidence-based nursing intervention in anorectal surgery can shorten the treatment time， promote the recovery of patients after surgery， and have positive significance for the prevention of dysuria， worthy of clinical application.

[Key words] Evidence-based care; Anorectal surgery; Voiding dysfunction; Anal voiding time; Residual urine volume of the bladder; Maximal urinary flow rate

肛肠疾病是临床常见疾病，多发生在大肠与肛门部位，常见疾病种类包括混合痔、结直肠肿瘤、肛瘘、肛周脓肿、肛乳头肥大等。临床治疗以手术治疗为主，并取得良好治疗效果[1-2]。但肛肠术后若对患者护理不当，将会带来术后疼痛、创面难愈合及术后排尿障碍等并发症，严重影响患者康复进程，严重患者甚至会造成伤口裂开及电解质紊乱等不良后果，导致患者生活质量明显下降[3-4]。因此在手术中为患者实施有效的护理干预对预防术后排便障碍，提高手术和预后效果，促进患者早日康复有重要临床意义[5-6]。本研究纳入我院收治的100例肛肠术患者，探讨循证护理对预防肛肠手术患者术后排尿障碍的临床价值，现报道如下。……