护理程序在内镜支架置入术治疗结直肠癌性梗阻中的应用:内镜下支架置入术
时间：2019-05-13 03:16:55 来源：雅意学习网 本文已影响 人 
【中图分类号】R473.73 【文献标识码】A 【文章编号】1672－3783(2012)06－0009－01 【摘要】 目的：探讨经内镜支架置入术治疗结直肠癌性梗阻的护理程序，总结护理经验。方法：选取经内镜放置金属支架治疗的21例结直肠癌性梗阻患者，通过病情评估、护理诊断、制定护理计划并实施，采用EROTC生命质量测定量表QLQ-C30（v3.0）中文版和肠梗阻症状评分量表进行评分，进行临床护理满意度调查，对临床护理效果进行评价。结果：21例结直肠癌性梗阻患者，总的操作成功率达95.2%(20/21)，临床有效率为90.5%(19/21)。术后1周的肠梗阻症状评分提示经支架治疗后症状较术前明显缓解，有统计学意义。QLQ-C30的统计结果提示患者术后的总体生活质量、躯体、角色、情绪等功能领域都有很大的改善。通过临床护理满意度调查显示，总体满意率达100%。结论：通过实施护理程序，制定合理的护理计划，使结直肠癌性梗阻患者生理、心理及社会功能得到最大限度的改善。
【关键词】 支架置入术；肠梗阻；癌性梗阻；护理程序
【Abstract】Objective: To explore the nursing program of colorectal carcinomatous obstruction treated by the endoscopic stent placement, summarize the nursing experience. Methods: The 21 patients of colorectal carcinomatous obstruction treated by the endoscopic stent placement, through the disease assessment, nursing diagnosis, making the plan of care and implement, using the Chinese version’s table of EROTC quality of life determination QLQ-C30(v3.0) and obstruction symptom scores rating scale to evaluating clinical care satisfaction and clinical nursing effect. Result: In 21 cases of colorectal cancer patients with obstruction, the total operation success rate was 95.2% (20/21),and the clinical effective rate was 90.5% (19/21). The symptom score of intestinal obstruction after one week of operation prompted the treatment of endoscopic stent placement symptoms was more effective, with a statistical significance. The statistical results of QLQ-C30 suggested that the function domain such as overall quality of life after surgery, body, role, emotion have greatly improved. Through the clinical care satisfaction survey showed overall satisfaction rate was 100%. Conclusion: Through the holistic nursing care, formulated reasonable care plan, maked sure that the physiology, psychological and social function of colorectal carcinomatous patients with obstruction getted maximum improvement.
结直肠恶性狭窄或梗阻是结直肠疾病的常见并发症，内镜治疗由于损伤少、风险小、可反复使用、费用低廉等优点，逐渐被广大临床工作者使用。通过内镜行支架置入术能够缓解急性肠道梗阻，成为临床姑息治疗的常用技术，同时为根治性手术治疗提供了良好的手术环境，减少手术造瘘机会和并发症的发生率［1］。我院2010年至2011年，对21例患直肠、乙状结肠癌患者采用经内镜金属支架置入术，通过护理程序的应用，护理疗效满意。现将护理体会介绍如下。
