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find Author "张雨晨" 10 results
  • 日间腹腔镜下胆囊切除术患者出院准备度与出院指导质量现状调查及相关性分析

    目的 探讨行日间腹腔镜下胆囊切除术患者出院准备度及出院指导质量现状,并分析两者相关关系。 方法 2015年8月-10月,采用便利抽样,对日间手术病房行腹腔镜下胆囊切除术患者进行问卷调查,运用出院准备度量表和出院指导质量量表,分析二者的关系。 结果 91.07%的日间腹腔镜下胆囊切除术患者表示准备好了出院,出院准备度总表得分为(93.55±12.18)分,处于较高水平,出院指导总表得分为(100.51±11.01)分,处于较高水平,出院准备和出院指导质量呈正相关(P<0.05)。 结论 日间腹腔镜下胆囊切除术患者的出院准备度较好,但出院后仍需继续在家康复;病房出院指导质量较好,仍需加强日间护理人员出院指导能力的培养。

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  • 日间手术模式接受意愿及满意度调查分析

    目的 调查日间手术患者对日间手术模式的接受意愿及其原因分析。 方法 采用问卷调查法,对2015年6月-8月日间手术的患者实施调查。由调查者于床旁亲自发放问卷,问卷当场回收。 结果 调查共发放问卷110份,回收有效问卷110份,有效率为100%。10例(9.1%)表示非常了解日间手术模式,34例(30.1%)表示了解日间手术模式,12例(10.7%)表示对日间手术模式了解一般,14例(12.5%)表示对日间手术模式不了解,40例(36.6%)表示对日间手术模式非常不了解。91例(82.7%)表示通过医生介绍知道日间手术模式的特点,28例(25.5%)通过亲朋好友的介绍了解一些日间手术模式的特点。98例(89.1%)表示通过住院知晓了日间手术模式的特点和相关信息,12例(10.9%)表示未获得日间手术模式的特点和相关信息。104例(94.5%)表示愿意接受日间手术模式。大部分患者愿意接受日间手术模式的原因是缩短了住院等候时间和治疗时间;不愿意接受日间手术模式的患者主要是担心出院后无医务人员的治疗和护理,影响术后的恢复。患者对就医过程、治疗效果、医护人员服务态度、出院指导均有较高的满意度,分别为96.4%、95.5%、99.1%和90.9%。 结论 日间手术模式是一种安全、快捷的手术模式,患者虽了解程度较低,但亲自体验后仍给予了高度认可。

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  • Application of Nursing Measures Based on the Concept of Enhanced Recovery after Surgery for Patients Undergoing Day Surgery of Inguinal Hernia Repair

    Objective To explore the clinical efficacy of nursing measures based on the concept of enhanced recovery after surgery (ERAS) for patients undergoing day surgery of inguinal hernia repair. Methods A total of 120 patients scheduled for day surgery of inguinal hernia repair between January and June 2015 were randomized into ERAS group (n=60) and control group (n=60). Patients in the ERAS group received nursing optimized by the idea of ERAS during the perioperative period, while those in the control group received traditional routine nursing intervention. Postoperative visual analogue scale (VAS) scores, adverse responses, early ambulation, influence of pain on patients’ sleep, satisfaction of the patients and prolonged hospital stay rate were analyzed and compared between the two groups. Results VAS scores during hours 0-2, 2-4, 4-8, and 8-12 in the ERAS group were significantly lower than those in the control group (P < 0.05). Between hour 12 and 24, the VAS sco res were not significantly different between the two groups of patients (P > 0.05). Early postoperative ambulation, influence of pain on the sleep, and patients’ satisfaction on pain control and nursing care in the ERAS group were all significantly better than those in the control group (P <0.05). Conclusion Based on the concept of ERAS nursing intervention model, we can effectively reduce postoperative complications after inguinal hernia repair, accelerate patients’ postoperative rehabilitation, and increase patients’ satisfaction.

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  • 华西日间手术护理管理制度规范构建与实践

    日间手术模式在欧美国家已经开展 30 余年,并建立了一系列的管理规范。近年,我国许多省市也开始开展日间手术模式,但仍处于探索之中,各种管理规范尚未建立,患者的医疗护理问题仍然突出。该文对四川大学华西医院日间手术护理管理制度规范从构建与实践方面进行介绍,以期为后续研究提供参考依据。

    Release date:2017-04-19 10:17 Export PDF Favorites Scan
  • 日间手术护理任重道远

    Release date:2017-11-24 10:58 Export PDF Favorites Scan
  • 四川大学华西医院日间手术护理规范

    近年来日间手术在国内得到大力推广,然而国内的日间手术尚处于发展阶段,日间手术护理更是处于探索阶段。四川大学华西医院日间手术中心作为最早规范化开展日间手术的医疗机构之一,制定了日间手术护理规范。该文通过介绍四川大学华西医院日间手术护理入院前、住院期间及出院后的护理规范,以期为全国日间手术护理的规范化开展提供参考依据。

    Release date:2017-11-24 10:58 Export PDF Favorites Scan
  • Establishment of a quality-sensitive indicator system for day surgery nursing

    ObjectiveTo establish a systematic, scientific, and sensitive index system to provide a scientific basis for quality evaluation and comprehensive quality management of day surgery nursing.MethodsThe databases of Wanfang, China National Knowledge Infrastructure, CQVIP, PubMed, and Web of Science were searched. The retrieval time was from the establishment of the databases to 15th July, 2019. Based on the “structure-process-outcome” management model, Delphi method was used to conduct two rounds of expert consultation for nursing experts related to day surgery in five tertiary hospitals. The results of the consultation were sorted out and the consensus of experts was obtained, so as to determine the quality-sensitive indicators of day surgery nursing.ResultsA total of 20 nursing experts participated in the questionnaire survey. The final evaluation indicators determined by expert correspondence included 1 structural indicator, 9 process indicators, and 4 outcome indicators.ConclusionsThe construction of quality evaluation standard of day surgery nursing not only embodies the connotation of nursing management of day surgery, but also puts forward clear requirements and quality standards for specialized nursing management. It has high reliability, scientificity, and strong operability, which can effectively improve the quality of nursing management and service level of day surgery.

    Release date:2021-03-19 01:22 Export PDF Favorites Scan
  • Analysis of nursing intervention on pain relieving after ambulatory laparoscopic cholecystectomy

    Objective To analyze the clinical effect of individualized pain nursing intervention on the pain relieving after ambulatory laparoscopic cholecystectomy (LC) . Methods From March to June 2017, a total of 180 ambulatory LC patients were selected and randomly asigned into the control group and the intervention group with 90 cases in each group. Parecoxib sodium (40 mg) was preoperatively administrated half an hour before the surgery to the patients in both of the two groups. The patients in the control group were treated with routine nursing intervention, while the ones in the intervention group were given individualized pain nursing interventions, including regular pain assessment, preoperative pain health guidance, enhanced education for pain related knowledge, and following the nursing theory of enhanced recovery after surgery. Visual Analogue Scale (VAS) was used to measure the degree of postoperative pain, and the data of dormant pain were collected. Results There was no significant difference between the two groups in VAS one hour after the operation (P>0.05); the VAS scores 2, 6 and 12 hours after the operation gradually decreased in the two groups (P<0.05), and the scores of patients in the intervention group were much lower than those in the control group (P<0.05). The time of pain relieving in the intervention group and the control group was (3.25±1.72) and (5.39±2.06) hours, respectively, and the difference was statistically significant (P<0.05). The incidence of dormant pain in the intervention group (12.2%) was lower than that in the control group (33.3%), and the difference was statistically significant (P<0.05). Conclusion Individualized pain nursing interventions can effectively alleviate the postoperative pain and improve the quality of sleep in ambulatory LC patients.

    Release date:2017-11-24 10:58 Export PDF Favorites Scan
  • Application of three-dimensional visualization technique in complex abdominal incisional hernia: an experience of 48 cases

    ObjectiveTo evaluate the application value of three-dimensional visualization (3DV) technique in the reconstruction of complex abdominal incisional hernia. MethodsThe clinical data of the patients with complex abdominal incisional hernia admitted to the West China Hospital of Sichuan University from September 2021 to September 2022 were collected. The area of abdominal wall defects was analyzed by Medraw software and reconstructed using 3DV technique, then the classifying and partition of abdominal wall defects were performed, the hernia sac/ intraabdominal volume ratio was calculated, patch size was estimated, and intraabdominal pressure values at 24 h and 48 h after surgery as well as operation time, complications were recorded. ResultsA total of 48 patients with complex abdominal incisional hernia were enrolled, including 30 cases of midline abdominal incisional hernia and 18 cases of other sites. There were 13 cases of moderate hernia, 19 cases of large hernia, and 16 cases of huge hernia. The abdominal wall defect area measured by 3DV technique for the 48 patients was (92.11±60.25) cm2, the hernia sac / intraabdominal volume ratio was (7.7±5.2)%, and the actual defect area measured intraoperatively was (89.20±57.38) cm2. Pearson correlation analysis showed a positive correlation between the preoperative 3DV measurement and intraoperative measurement (r=0.959, P<0.001). The operation time was (73.5±8.2) min, postoperative anal exhaust time (31.66±15.32) h, intraabdominal pressures at 24 h and 48 h postoperatively were (13.50±2.12) mmHg and (11.39±1.42) mmHg, respectively. The patient’s hospitalization time was (7.12±1.21) d. Among the 48 patients, 7 cases (14.58%) experienced complications after surgery, recovered smoothly after conservative treatment and no unplanned reoperation was required. All patients were followed up for 18–32 months with a median time of 26 months, and no long-term hernia recurrence was observed. ConclusionFrom the analysis results of this study, it can be seen that the application of 3DV technique to evaluate complex abdominal wall defects can assist hernia surgeons to make a correct choice and has a better safety and effect.

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  • Preliminary exploration of day surgery management model in West China Hospital of Sichuan University

    Since its establishment in 2009, adhering to the concept of patient-centered service, the Day Surgery Center of West China Hospital of Sichuan University has been improving the management model constantly, and perfecting the service process gradually, to ensure the medical quality and safety of the hospital, and optimize the utilization of medical resources. In view of the management of day surgery, the hospital has formulated a sound patient access system, surgeon access principle, standardized appointment process and contingency plans, and made changes in patient admission process, responsibilities of surgeons, and nursing care comparing with the traditional hospital operation. The purpose of this paper is to introduce the management model of day surgery in West China Hospital of Sichuan University, discuss the clinical application of centralized and decentralized management in combination with the actual situation, and explore the model of day surgery with high applicability and more consistent with our national conditions.

    Release date:2019-02-21 03:19 Export PDF Favorites Scan
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