【摘要】 目的探讨专案管理对恶性梗阻性黄疸行腹腔镜胰十二指肠切除(LPD)患者围手术期健康知识规范执行率的影响。方法将2018年3～6月未实施专案管理时恶性梗阻性黄疸行LPD患者30例作为对照组;2018年8～11月实施专案管理后同类患者30例作为观察组。科室成立专案管理小组,对LPD患者术前禁食水和术后饮水进食时间、下肢活动的方法频率和幅度、术后咀嚼口香糖时间和频率、术前刷牙漱口执行情况、有效咳嗽咳痰情况几方面进行健康知识掌握和规范执行情况现状调查,对存在问题项目进行根本原因分析,提出改进措施并实施,并比较专案管理前与专案管理后患者对健康知识掌握和规范执行情况、相关并发症发生情况、患者焦虑抑郁状态及满意度情况。结果实施专案管理后,观察组患者健康知识知晓率和规范执行率由改善前的62.22%提高至91.85%,并发症发生率由改善前的26.67%下降到6.67%,患者焦虑抑郁程度评分及住院期间满意度也得到了明显改善,差异均有统计学意义(P<0.05)。结论实施专案管理可有效提高恶性梗阻性黄疸行LPD患者围术期健康知识知晓率和规范执行率,提升了护理质量,降低了并发症的发生,明显改善了患者的焦虑抑郁状态,同时提高了患者住院期间的满意度。更多还原

【Abstract】 Objective To investigate the effects of project management on the implementation rate of perioperative health knowledge in patients with malignant obstructive jaundice undergoing laparoscopic pancreaticoduodenectomy(LPD).Methods A total of 30 patients with malignant obstructive jaundice who underwent LPD without project management from March 2018 to June 2018 were enrolled as control group,and the other 30 patients with malignant obstructive jaundice who underwent LPD and project management from August 2018 to November 2018 were enrolled as observation group.The department set up a project management team to analyze the time and frequency of fasting water and postoperative drinking time,the frequency and extent of lower limb movements,the time and frequency of chewing gum,the performance of brushing and rinsing before surgery,and effective cough and sputum.Moreover the survey health status and implementation status of health knowledge in several aspects were investigated to analyze the origin cause of existing problems,propose improvement measures,and to compare the changes of health knowledge status and implementation status and related complications as well as anxiety,depression,and satisfaction degree of patients before and after the project management.Results After project management,the awareness rate and normative implementation rate of patients in observation group were increased from 62.22% to 91.85%,and the incidence rate of complication ratewas decreased from 26.67% to 6.67%.Moreover the anxiety and depression scores and satisfaction degree of patients during hospitalization were improved significantly(P<0.05).Conclusion The implementation of project management can effectively improve the perioperative health knowledge awareness rate and standard implementation rate of patients with malignant obstructive jaundice after LPD,improve the nursing quality,reduce the occurrence of complications,and significantly improve the anxiety and depression status of patients,and improve the satisfaction degree of patients during hospitalization.更多还原