临床护理路径在白内障合并青光眼中的应用效果

摘要

目的 探讨临床护理路径(clinical nursing pathway,CNP)在白内障合并原发性闭角型青光眼(primary angel-closure glaucoma,PACG)围术期的应用效果,为提高临床护理质量提供理论基础.方法 选取恩施州中心医院眼科中心2008年1月～2011年2月白内障合并PACG住院患者211例(232眼),随机分为实验组(116例,130眼)和对照组(95例,102眼).对照组采用常规护理规范进行护理,实验组用临床护理路径进行护理指导,观察其应用效果.结果 实验组术前血压、心率及不良反应发生率均低于对照组(P＜0.05)；治疗后两组患者眼压、前房深度、视力指标均得到改善,实验组治疗后效果优于对照组,差异有统计学意义(P＜0.05).实验组患者护理满意度明显高于对照组,差异有高度统计学意义(P＜0.01).与对照组相比,实验组患者的平均住院天数、住院费用、并发症发生率、以及术后复发率均明显降低,差异有统计学意义(P＜0.05).结论 采用临床护理路径模式进行心理及行为干预护理,可以降低患者术前焦虑程度,显著提高手术治疗效果和患者满意度,缩短住院天数,减少住院费用,降低术后复发率.%Objective To explore the application effect of clinical nursing pathway (CNP) in cataract with primary angel-closure glaucoma before and after operation, in order to improve the quality of clinical nursing.Methods 211 cases (232 eyes) were randomly divided into two groups in control hospital of Enshi Autonomous Prefecture in January 2008 to February 2011, the control group was given conventional nursing with standard, and the experiment group was given CNP, the effect of two groups were observed.Results Blood pressure, heart rate and the incidence of adverse reactions in the experiment group before operation were lower than that of the control group; intraocular pressure, anterior chamber depth and eyesight indicators were improved in the two groups after treatment, and the effect of the experiment was better than that of the control after treatment (P < 0.05).Nursing satisfaction improved significantly in the experiment (P < 0.01).There were distinct differences between two groups in hospital expenses, average hospital days, the complication rate and postoperative recurrence rate.Conclusion Using CNP in psychological and behavioral nursing intervention can obviously improve the nursing care quality, lower preoperative anxiety level before operation, and reduce the medical cost, inpatient days and postoperative recurrence rate in cataract with PACG.