基于结构化质量改进的早期活动在ICU肝移植术后患者中的应用研究

doi:10.3761/j.issn.2096-7446.2023.03.002

摘要/Abstract

摘要： 目的研究基于结构化质量改进的早期活动在ICU肝移植术后患者中的应用效果。方法便利选取北京市某三级甲等医院ICU 2019年9月—2022年5月收治的肝移植患者为研究对象,按手术先后顺序分组,2021年1月—2022年5月的63例患者为试验组,实施基于结构化质量改进的早期活动,2019年9月—2020年12月的62例患者为对照组,实施常规早期活动。比较两组出ICU及出院压力性损伤风险等级、出ICU及出院日常生活自理能力等级、术后疼痛情况、下肢深静脉血栓发生率。结果试验组出ICU压力性损伤风险等级低于对照组,出ICU及出院日常生活活动能力等级高于对照组,差异具有统计学意义（P<0.05）;试验组术后疼痛13例（2.06%）与对照组术后疼痛12例（1.93%）相比,差异无统计学意义（P>0.05）;试验组未发生下肢深静脉血栓,对照组发生1例（1.6%）下肢深静脉血栓（P>0.05）。结论基于结构化质量改进制订ICU肝移植术后患者早期活动护理计划,有助于降低患者压力性损伤风险,提高肝移植术后患者的自理能力,提高患者生活质量。

关键词: 肝移植, 结构化质量改进, 重症监护病房, 早期活动, 危重病护理

Abstract: Objective To study the effect of early activity based on structured quality improvement in ICU patients after liver transplantation. Methods Liver transplantation patients admitted to the ICU of a tertiary class A hospital in Beijing from September 2019 to May 2022 were selected as the study objects. Sixty-three patients from January 2021 to May 2022 were included into experimental groups according to the order of surgery. Early activities based on structured quality improvement were carried out. A total of 62 patients from September 2019 to December 2020 served as the control group and received routine early activities. The risk level of pressure injury after ICU and discharge,the level of daily self-care ability after ICU and discharge,postoperative pain,and the incidence of deep venous thrombosis of lower limbs were compared between the two groups. Results The risk level of pressure injury out of ICU in experimental group was lower than that in control group,and the level of daily living activity ability out of ICU and out of hospital was higher than that in control group,the difference was statistically significant（P<0.05）. 13 patients（2.06%）had postoperative pain in the experimental group and 12 patients（1.93%）in the control group,the difference was not statistically significant（P>0.05）. No deep vein thrombosis occurred in the experimental group,and 1 case（1.6%）in the control group（P>0.05）. Conclusion The early activity nursing plan of ICU patients after liver transplantation based on structured quality improvement is helpful to reduce the risk of pressure injury,improve the self-care ability of patients after liver transplantation,and improve the quality of life of patients.

Key words: Liver Transplantation, Structured Quality Improvement, Intensive Care Units, Early Activity Care, Critical Care Nursing

吴正芳, 杨丽娜, 张微微. 基于结构化质量改进的早期活动在ICU肝移植术后患者中的应用研究[J]. 中华急危重症护理杂志, 2023, 4(3): 202-207.

WU Zhengfang, YANG Lina, ZHANG Weiwei. Study on the application effect of early activity based on structured quality improvement in ICU patients after liver transplantation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(3): 202-207.

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