陳瑞燕
【摘要】 目的:分析體位性低血壓(OH)的護(hù)理干預(yù)在泌尿外科老年患者中的應(yīng)用研究。方法:選取80例泌尿外科圍術(shù)期發(fā)生體位性低血壓的老年患者,隨機(jī)分為觀察組(n=40)和對(duì)照組(n=40)。對(duì)照組行常規(guī)護(hù)理,觀察組則采用針對(duì)性護(hù)理干預(yù)。比較兩組患者入院前后患者體位性低血壓知曉率評(píng)分、患者1周內(nèi)跌倒發(fā)生率及護(hù)理滿意度。結(jié)果:兩組入院前各項(xiàng)指標(biāo)差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05);觀察組出院時(shí),OH知曉率評(píng)分明顯高于對(duì)照組,而住院期間觀察組1周內(nèi)跌倒發(fā)生率低于對(duì)照組(P<0.05);同時(shí)護(hù)理滿意度觀察組(95.0%)高于對(duì)照組(75.0%),差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論:針對(duì)關(guān)鍵危險(xiǎn)因素行針對(duì)性護(hù)理干預(yù),可有效提升泌尿外科圍術(shù)期老年體位性低血壓患者對(duì)OH的認(rèn)識(shí),降低OH對(duì)患者的損害,進(jìn)而提高護(hù)理滿意度。
【關(guān)鍵詞】 針對(duì)性護(hù)理 老年 泌尿外科 圍術(shù)期 體位性低血壓
doi:10.14033/j.cnki.cfmr.2020.15.052 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805(2020)15-0-03
Research on Nursing Intervention of Orthostatic Hypotension in Elderly Patients in Urology/CHEN Ruiyan. //Chinese and Foreign Medical Research, 2020, 18(15): -127
[Abstract] Objective: To analyze the application of orthostatic hypotension nursing intervention in elderly patients of urology. Method: A total of 80 elderly patients with orthostatic hypotension during perioperative period of urology were selected and randomly divided into observation group (n=40) and control group (n=40). The control group received routine nursing, and the observation group adopted targeted nursing intervention. Compared the two groups of patients with orthostatic hypotension awareness rate scores, incidence of falls within 1 week, and nursing satisfaction before and after admission. Result: There were no significant differences between the two groups before admission (P>0.05). When the observation group was discharged, the score of OH awareness rate was significantly higher than that of the control group, and the incidence of falls within 1 week of the observation group was lower than that of the control group (P<0.05). At the same time, the nursing satisfaction of observation group was 95.0% which higher than 75.0% of the control group, and the difference was statistically significant (P<0.05). Conclusion: Targeted nursing interventions for key risk factors can effectively improve the awareness of OH in elderly patients with orthostatic hypotension during perioperative period of urological surgery, reduce the damage caused by OH to patients, and then improve nursing satisfaction.
[Key words] Targeted nursing Elderly Urology Perioperative period Orthostatic hypotension
First-authors address: Wuchuan Peoples Hospital, Wuchuan 524500, China
體位性低血壓(orthostatic hypotension,OH)是指由人的體位變化引起的血壓下降[1-2],通過(guò)一定的研究發(fā)現(xiàn)體位性低血壓經(jīng)常出現(xiàn)在夜間,由于泌尿外科老年患者多會(huì)出現(xiàn)夜尿增多的情況,如果此時(shí)出現(xiàn)體位性低血壓,很容易導(dǎo)致暈倒、暈厥或者心絞痛等心腦血管缺血癥狀[3-5],從而對(duì)老年人的身體造成一定危害。本院早期調(diào)查顯示,護(hù)士及患者對(duì)OH知曉率較低,為此自2018年12月起針對(duì)護(hù)理人員進(jìn)行OH理論知識(shí)全科護(hù)理培訓(xùn),對(duì)OH患者進(jìn)行針對(duì)性護(hù)理干預(yù),并取得較好效果,現(xiàn)報(bào)道如下。
綜上所述,針對(duì)關(guān)鍵危險(xiǎn)因素行針對(duì)性護(hù)理干預(yù),有效提升泌尿外科圍術(shù)期老年體位性低血壓患者對(duì)OH的認(rèn)識(shí),降低OH對(duì)患者的損害,進(jìn)而提高護(hù)理滿意度,值得推廣。
參考文獻(xiàn)
[1]程昌艷.老年體位性低血壓患者臨床護(hù)理效果分析[J].華南國(guó)防醫(yī)學(xué)雜志,2015,29(1):71-73.
[2]王曉蕾,張楠,張嵐.壓力梯度長(zhǎng)襪預(yù)防老年重癥患者深靜脈血栓形成和體位性低血壓的效果觀察[J].天津護(hù)理,2016,24(4):293-295.
[3]秦莉.體位性低血壓節(jié)律評(píng)估用于老年高血壓患者護(hù)理中的作用分析[J].國(guó)際醫(yī)藥衛(wèi)生導(dǎo)報(bào),2019,25(6):966-968.
[4]譚英葵,農(nóng)冬暉,高熙,等.老年體位性低血壓及其護(hù)理干預(yù)研究進(jìn)展[J].內(nèi)科,2018,13(4):633-635.
[5]耿慧,陳夏歡,杜佳麗,等.采用連續(xù)無(wú)創(chuàng)血壓監(jiān)測(cè)系統(tǒng)監(jiān)測(cè)老年住院患者體位改變時(shí)血壓的變化情況及其相關(guān)因素分析[J].中華心血管病雜志,2019,47(5):381-387.
[6]祖麗菲婭·木沙,胡爾西旦·那斯?fàn)枺箍枴ど潮忍?老年高血壓患者變換體位造成血壓改變的特點(diǎn)及其并存神經(jīng)認(rèn)知障礙的臨床分析[J].實(shí)用老年醫(yī)學(xué),2016,30(8):648-650.
[7]張潔.高齡老人體位性血壓變化與動(dòng)脈粥樣硬化的相關(guān)性研究[J].中華老年心腦血管病雜志,2017,19(5):483-487.
[8]張海榮,王莉萍.腦血管病患者繼發(fā)體位性低血壓的安全護(hù)理[J].護(hù)士進(jìn)修雜志,2013,28(10):903-904.
[9]陶思怡,黃金文.1例善思達(dá)引起體位性低血壓病人的護(hù)理[J].全科護(hù)理,2015,13(9):863-864.
[10]陳娜麗,崔智君,李秀川,等.5A模式護(hù)理干預(yù)方案在老年人體位性低血壓中的應(yīng)用[J].蚌埠醫(yī)學(xué)院學(xué)報(bào),2017,10(42):1399.
[11]韋玉敏.健康教育在老年高血壓病護(hù)理中的應(yīng)用[J].大家健康:學(xué)術(shù)版,2016,10(6):21-22.
[12]高媛媛,李麗華.體位性低血壓節(jié)律評(píng)估在老年高血壓患者護(hù)理中的應(yīng)用[J].中國(guó)病案,2017,18(6):110-112.
(收稿日期:2020-01-03) (本文編輯:張亮亮)