山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (3): 134-137.doi: 10.6040/j.issn.1673-3770.1.2018.045

• 护理园地 • 上一篇    下一篇

综合护理干预对鼻内镜鼻窦手术后口干症的改善效果观察

万文锦1,闫玉洁1,黎娜1,郭人毓1,袁慧2()   

  1. 1. 南京医科大学第一附属医院 江苏省人民医院耳鼻咽喉科
    2. 南京医科大学第一附属医院 江苏省人民医院大外科,江苏 南京 210029
  • 收稿日期:2018-12-14 修回日期:2019-04-17 出版日期:2019-05-20 发布日期:2019-08-07
  • 通讯作者: 袁慧 E-mail:419501794@qq.com

Comprehensive intervention on xerostomia after functional endoscopic sinus surgery

Wenjin WAN1,Yujie YAN1,Na LI1,Renyu GUO1,Hui YUAN2()   

  1. 1. Department of Otorhinolaryngology
    2. Department of Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Received:2018-12-14 Revised:2019-04-17 Online:2019-05-20 Published:2019-08-07
  • Contact: Hui YUAN E-mail:419501794@qq.com

摘要: 目的

探讨综合护理干预对功能性内镜鼻窦手术(FESS)患者术后口干症的改善效果。

方法

选取2018年5月1日至2018年9月30日行FESS手术的97例患者为研究对象,随机分为对照组与观察组。对照组48例,采用常规护理;观察组49例,实施针对口干症的综合护理干预措施。对比两组患者口干症的改善情况,并比较患者的舒适度和满意率。

结果

观察组术后3 h、6 h、1 d、2 d的口干分级为(2.06±0.59)、(1.20±0.50)、(0.98±0.66)、(0.35±0.48)级,均明显低于对照组的(3.40±0.54)、(3.75±0.48)、(3.06±0.32)、(2.38±0.49)级,差异有统计学意义(P<0.05);观察组的舒适度(5.47±0.65)分,优于对照组的(3.35±0.64)分,差异有统计学意义(P <0.05);观察组的满意率99.8%,高于对照组的87.5%,差异有统计学意义(P <0.05)。

结论

综合护理干预可以有效改善FESS术后患者的口干症,增加患者舒适度,提高患者满意度。

关键词: 护理估计, 鼻窦炎, 内窥镜检查, 口腔干燥

Abstract: Objective

To explore the effect of comprehensive intervention on xerostomia after functional endoscopic sinus surgery (FESS).

Methods

A total of 97 patients with FESS from May 1, 2018, to September 30, 2018, were randomly divided into two groups. The control group was treated with usual nursing, while the observation group was given comprehensive intervention. The improvement of the patients' xerostomia and their comfort and satisfaction rates were compared between two groups.

Results

The xerostomia grading of patients who underwent FESS at three hours, six hours, one day, and two days after the surgery was 2.06 ± 0.59, 1.20 ± 0.50, 0.98 ± 0.66, and 0.35 ± 0.48 respectively in the observation group, and 3.40 ± 0.54, 3.75 ± 0.48, 3.06 ± 0.32, and 2.38 ± 0.49 respectively in the control group. The degree of comfort was 5.47 points in the observation group, and 3.35 points in the control group. The satisfaction rates were significantly higher in the observation group (99.8%) than in the control group (87.5%). All the differences were statistically significant (P < 0.05).

Conclusion

The comprehensive intervention effectively improved xerostomia in patients who underwent FESS, increased their degree of comfort, and improved patients' satisfaction.

Key words: Nursing assessment, Sinusitis, Endoscopy, Xerostomia

中图分类号: 

  • R473.76,R765

表1

两组患者基本临床资料情况[例,(%)]"

组别性别诊断年龄(xˉ±s,岁)
鼻窦炎鼻息肉鼻中隔偏曲鼻出血鼻肿物其他

对照组

(n=48)

31(64.6)17(35.4)19(39.6)10(20.8)5(10.4)3(6.3)8(16.7)3(6.3)51.88±11.72

观察组

(n=49)

31(63.3)18(36.7)22(44.9)6(12.2)3(6.1)6(12.2)7(14.3)5(10.2)45.92±17.51
χ2/t0.0183.3171.972
P0.8920.6510.052

表2

FESS术后口干分级及舒适度评分(xˉ±s)"

组别术后口干分级术后舒适度
术后3 h术后6 h术后1 d术后2 d平均
对照组(n=48)3.40±0.543.75±0.483.06±0.322.38±0.493.15±0.263.35±0.64
观察组(n=49)2.06±0.591.20±0.500.98±0.660.35±0.481.15±0.475.47±0.65
t11.6425.5019.8120.5926.15-16.22
P<0.001<0.001<0.001<0.001<0.001<0.001

表3

两组患者满意率比较[n(%)]"

组别非常满意比较满意一般不太满意非常不满意满意率
对照组(n=48)18(37.5)24(50.0)4(8.3)2(4.2)042(87.5)
观察组(n=49)30(61.2)18(36.8)1(0.2)0(0)048(99.8)
χ27.095
P0.046
1 杜德顺. 口干、口干燥症及其治疗进展[J]. 中华临床医师杂志(电子版), 2008, 2(9): 986-992. doi:10.3969/j.issn.1674-0785.2008.09.003.
doi: 10.3969/j.issn.1674-0785.2008.09.003
DUDeshun. Dry mouth, dry mouth syndrome and their treatment[J]. Chinese Journal of Clinicians(Electronic Version), 2008, 2(9): 986-992. doi:10.3969/j.issn.1674-0785.2008.09.003.
doi: 10.3969/j.issn.1674-0785.2008.09.003
2 NascimentoLA, FonsecaLF, RossetoEG, et al. Development of a safety protocol for management thirst in the immediate postoperative period[J]. Rev Esc Enferm USP, 2014, 48(5): 834-843.doi:10.1590/s0080-62342014-00005000009.
doi: 10.1590/s0080-62342014-00005000009
3 龚丽. 心脏瓣膜病术后患者口渴相关因素及干预研究[D]. 郑州: 郑州大学, 2015.
4 沈莹, 郝敬荣, 刘文娟, 等. 缩唇腹式呼吸训练改善老年慢性心力衰竭患者睡眠障碍的护理研究[J]. 中国实用护理杂志, 2017, 33(12): 904-907. doi:10.3760/cma.j.issn.1672-7088.2017.12.006.
doi: 10.3760/cma.j.issn.1672-7088.2017.12.006
SHENYing, HAOJingrong, LIUWenjuan, et al. Nursing study in abdominal breathing training ameliorating sleep status in elderly patients with chronic heart failure[J]. Chinese Journal of Practical Nursing, 2017, 33(12): 904-907. doi:10.3760/cma.j.issn.1672-7088.2017.12.006.
doi: 10.3760/cma.j.issn.1672-7088.2017.12.006
5 张小林, 袁海娟. 洼田饮水试验在122例头颈部患者中的评估性应用[J]. 实用临床护理学电子杂志, 2017, 2(26): 173-174. doi:10.3969/j.issn.2096-2479.2017.26.139.
doi: 10.3969/j.issn.2096-2479.2017.26.139
6 詹昱新, 欧阳燕, 廖兰, 等. 文丘里空氧混合阀联合面罩温湿化给氧在脑卒中患者的应用[J]. 护理学杂志, 2017, 32(15): 21-23. doi:10.3870/j.issn.1001-4152.2017.15.021.
doi: 10.3870/j.issn.1001-4152.2017.15.021
ZHANYuxin, OUYANGYan, LIAOLan, et al. Efficacy of oxygen therapy delivered through Venturi air-entrainment mask and heated humidification to patients with cerebral stroke[J]. Journal of Nursing Science, 2017, 32(15): 21-23. doi:10.3870/j.issn.1001-4152.2017.15.021.
doi: 10.3870/j.issn.1001-4152.2017.15.021
7 张小萍, 王晓琳, 黄佳, 等. 双糖口干缓解含漱液在鼻内镜术后患者口腔护理中的应用[J]. 临床医学工程, 2015, 22(12): 1657-1658. doi:10.3969/j.issn.1674-4659.2015.12.1657.
doi: 10.3969/j.issn.1674-4659.2015.12.1657
ZHANGXiaoping, WANGXiaolin, HUANGJia, et al. Application of disaccharide xerostomia catabatic gargle in mouth nursing of patients with nasal endoscopic surgery[J]. Clinical Medical & Engineering, 2015, 22(12): 1657-1658. doi:10.3969/j.issn.1674-4659.2015.12.1657.
doi: 10.3969/j.issn.1674-4659.2015.12.1657
8 赵伟鹏, 姜欣, 黄金昶. 针刺治疗放疗后口干症疗效观察[J]. 中国临床医生, 2015, 43(3): 80-82. doi:10.3969/j.issn.1008-1089.2015.03.029.
doi: 10.3969/j.issn.1008-1089.2015.03.029
9 FranciscoSC, BatistaST, PenaGD. Fasting in elective surgical patients: comparison among the time prescribed, performed and recommended on perioperative care protocols[J]. Arq Bras Cir Dig, 2015, 28(4): 250-254. doi:10. 1590/S0102-6720201500040008.
doi: 10. 1590/S0102-6720201500040008
10 王中和. 呼吁建立我国的口干燥症分级标准[J]. 中华口腔医学杂志, 2010, 45(8): 449-452. doi:10.3760/cma.j.issn.1002-0098.2010.08.001.
doi: 10.3760/cma.j.issn.1002-0098.2010.08.001
WANGZhonghe. Calling on establishment of grading standard for xerostomia in China[J]. Chinese Journal of Stomatology, 2010, 45(8): 449-452. doi:10.3760/cma.j.issn.1002-0098.2010.08.001.
doi: 10.3760/cma.j.issn.1002-0098.2010.08.001
11 纪静. 鼻内镜手术治疗慢性鼻窦炎30例围术期舒适护理[J]. 齐鲁护理杂志, 2015, 21(4): 35-36. doi:10.3969/j.issn.1006-7256.2015.04.015.
doi: 10.3969/j.issn.1006-7256.2015.04.015
12 杨小琼. 围手术期干预对鼻内镜手术患者术后心理状况及并发症的影响[J]. 临床合理用药杂志, 2018, 11(26): 166-167. doi:10.15887/j.cnki.13-1389/r.2018. 26. 110.
doi: 10.15887/j.cnki.13-1389/r.2018. 26. 110
13 秦薇. 择期手术患者术前禁食禁饮时间的研究进展[J]. 中华护理杂志, 2014, 49(1): 76-79. doi:10.3761/j.issn.0254-1769.2014.01.019.
doi: 10.3761/j.issn.0254-1769.2014.01.019
14 NygrenJ, ThackerJ, CarliF, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations[J]. World J Surg, 2013, 37(2): 285-305. doi:10. 1007/s00268-012-1787-6.
doi: 10. 1007/s00268-012-1787-6
15 de Aguilar-NascimentoJE, Dock-NascimentoDB. Reducing preoperative fasting time: a trend based on evidence[J]. World J Gastrointest Surg, 2010, 2(3): 57-60. doi:10.4240/wjgs.v2.i3.57.
doi: 10.4240/wjgs.v2.i3.57
16 刁齐翔, 陈玉红. 手术后患者口渴的护理研究进展[J]. 护理学杂志, 2017, 32(22): 106-110. doi:10.3870/j.issn.1001-4152.2017.22.106.
doi: 10.3870/j.issn.1001-4152.2017.22.106
DIAOQixiang, CHENYuhong. A literature review of interventions for postoperative thirst[J]. Journal of Nursing Science, 2017, 32(22): 106-110. doi:10.3870/j.issn.1001-4152.2017.22.106.
doi: 10.3870/j.issn.1001-4152.2017.22.106
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