观察临床路径在体外循环心脏瓣膜置换围手术期的应用效果及对患者睡眠质量的影响被引量：3

To Observe the Application of Clinical Pathway in Perioperative Period of Cardiopulmonary Bypass Cardiac Valve Replacement and its Effect on Sleep Quality of Patients

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摘要目的:观察临床路径在体外循环心脏瓣膜置换围手术期的应用效果及对患者睡眠质量的影响。方法:选取2019年3月至2020年6月东莞市人民医院收治的体外循环心脏瓣膜置换术患者72例作为研究对象,按照随机数字表法分为观察组和对照组,每组36例。对照组给予常规管理,观察组给予临床路径管理。采用焦虑自评量表(Self-rating Anxiety Scale,SAS)比较2组患者干预前后的焦虑状态改善情况,采用匹兹堡睡眠指数量表(Pittsburgh Sleep Quality Index,PSQI)比较2组患者干预前后睡眠质量变化情况,采用简易精神状态检查量表(Mini Mental Status Examination,MMSE)比较2组患者干预前后认知功能的变化,同时比较2组患者临床指标的变化,包括ICU停留时间、住院时间、平均住院费用、满意度评分等,比较2组患者并发症发生率。结果:干预后,观察组患者SAS评分、PSQI评分显著低于对照组,观察组MMSE评分显著高于对照组,观察组ICU停留时间、平均住院时间、平均住院费用均低于对照组,观察组患者治疗满意度显著高于对照组,观察组并发症发生率显著低于对照组,2组比较差异均有统计学意义(P<0.05)。结论:在体外循环心脏瓣膜置换术的围手术期应用临床路径管理方法可显著改善患者负性情绪,提升睡眠质量,有效避免出现术后认知障碍,降低并发症发生率,加快患者康复进程,降低患者在ICU的停留时间以及住院时间,提高治疗满意度,值得临床推广使用。 Objective:To observe the application of clinical pathway in perioperative period of cardiopulmonary bypass cardiac valve replacement and its effect on patients′sleep quality.Methods:A total of 72 patients with cardiopulmonary bypass cardiac valve replacement admitted to Dongguan People′s Hospital from March 2019 to June 2020 were selected as the research objects,and were divided into observation group and control group according to the random number table method,with 36 patients in each group.The control group was given routine management,and the observation group was given clinical pathway management.Self-rating Anxiety Scale(SAS)was used to compare the improvement of anxiety in 2 groups before and after intervention.Pittsburgh Sleep Quality Index(PSQI)were used to compare the changes of sleep quality between 2 groups,Mini Mental Status Examination(MMSE)were used to compare the changes of cognitive function in 2 groups before and after intervention,and compare the changes of clinical indicators at the same time,included ICU stay time,length of stay in hospital,average hospitalization cost and satisfaction score.At last,the incidence of complications was compared between the two groups.Results:After the intervention,SAS score and the PSQI score in the observation group was significantly lower than the control group,the MMSE score in the observation group was significantly higher than the control group,the ICU stay time,average hospital stay time,average hospitalization costs are lower than the control group,the patients satisfaction in the observation group was significantly higher than the control group,the incidence of complications rate was significantly lower than the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion:In extracorporeal circulation of heart valve replacement perioperative application of clinical pathway management method can significantly improve patients′negative mood,improve sleep quality and avoid the postoperative cognitive dysfunction,reduce the incidence of complications,speed up the therapy process,reduce the patients in the ICU stay time and length of hospital stay time,improve treatment satisfaction,It is worthy of clinical application.

作者杨明月秦志华徐丽梅 YANG Mingyue;QIN Zhihua;XU Limei(Dongguan People′s Hospital,Dongguan 523000,China)

机构地区东莞市人民医院

出处《世界睡眠医学杂志》 2022年第5期792-794,797,共4页 World Journal of Sleep Medicine

关键词临床路径体外循环心脏瓣膜置换围术期睡眠并发症管理认知障碍 Clinical pathway Cardiopulmonary bypass cardiac valve replacement Perioperative Sleep Complications Management Cognitive impairment