递进式目标护理对鼻中隔偏曲矫正术患者术后恢复效果及心理状态的影响

吴 玮　胡晓兰　何泽艳

[關键词]递进式目标护理;鼻中隔偏曲矫正术;术后恢复;心理状态;术后并发症

[中图分类号]R473.77    [文献标志码]B    [文章编号]1008-6455（2021）12-0156-04

The Influences of Progressive Goal Nursing on Postoperative Recovery Effect and Psychological Status of Patients Undergoing Nasal Septum Deviation plasty

WU Wei，HU Xiao-lan，HE Ze-yan

（Outpatient Department， West China Hospital， Sichuan University/West China School of Nursing， Sichuan University，Luzhou，Sichuan 610000，China）

Abstract： Objective  To explore the effects of progressive goal nursing on postoperative recovery effect and psychological status of patients undergoing nasal septum deviation plasty. Methods  A total of 98 patients who underwent nasal septum deviation plasty in the hospital from January to December 2019 were enrolled as the research objects. They were divided into observation group （n=49） and control group （n=49） by random number table method. The control group was given routine nursing intervention， while observation group was given progressive goal nursing intervention on basis of control group. Both groups were intervened for 7d. The scores of self-rating anxiety scale （SAS）， self-rating depression scale （SDS） and the MOS 36-Item Short Form Health Survey （SF-36） before and after intervention， scores of nasal visual analogue scale （VAS） at 2h， 12h， 24h and 48h after surgery， and incidence of complications during intervention were compared between the two groups. The hospitalization time and hospitalization cost in both groups were statistically analyzed. Results  SAS and SDS scores： After the intervention， the scores of the two groups were significantly lower than those before the intervention， the difference was statistically significant （P<0.05）， and the score of the observation group decreased more significantly （P<0.05）. VAS score： 12h after the operation， At 24h and 48h， the scores of the two groups were lower than 2h after the operation （P<0.05）， and the observation group was lower than the control group （P<0.05）. SF-36 score： After the intervention， the scores of the two groups were significantly higher than before the intervention （P<0.05）， and the scores of the observation group were higher than those of the control group （P<0.05）. During the intervention period， the complication rate of the observation group was 4.08% significantly lower than that of the control group 18.37% （P<0.05）. The length of hospitalization and hospitalization expenses were lower than those of the control group （P<0.05）. Conclusion  The application of progressive goal nursing in patients undergoing nasal septum deviation plasty can significantly improve their psychological status， alleviate postoperative nasal pain， reduce occurrence of postoperative complications， shorten hospitalization time， and improve their quality of life.

Key words： progressive goal nursing; nasal septum deviation plasty; postoperative recovery; psychological status; postoperative complication

鼻中隔偏曲是指鼻中隔局部偏向一侧形成“S”或“C”形的一种鼻内畸形，常表现为头痛、鼻出血、鼻塞等症状，可引起鼻窦和鼻腔功能障碍[1]，极易使患者心理健康受到影响，进而影响其正常生活。目前，临床上常采用的治疗鼻中隔偏曲的方法是鼻内镜下鼻中隔偏曲矫正术。术后患者相应不适症状可明显改善甚至消除，但患者对术中全身麻醉、创伤等情况又很容易产生恐惧和焦虑等不良心理情绪，加上术后长时间的禁饮禁食以及鼻腔填塞带来的疼痛等又会进一步加重患者的生理心理应激反应，各方面综合起来均不利于患者的术后恢复[2-3]。因此，临床上在积极治疗的同时采取科学合理的护理干预措施，以预防患者不良心理情绪的出现以及促进术后康复就显得很有必要。递进式目标护理是将临床护理过程分为若干个递进式护理目标并逐步实现的一种护理模式。有研究报道在膀胱肿瘤、股骨颈骨折等疾病患者的术后护理中使用递进式目标护理，患者术后不良心理情绪发生率降低，自我效能和术后康复效果得到了很大的提高[4-5]。目前，临床医生也开始在鼻中隔偏曲矫正术患者临床护理中使用此护理模式，但应用价值尚不明确。基于此，本研究将递进式目标护理应用于鼻中隔偏曲矫正术患者的临床护理中，探讨其对患者术后恢复效果及心理状态的影响，现报道如下。……