CAJ | 학술논문

目的：探讨整合医学模式下腹腔引流管管口渗液处理方法改进的效果。方法选取2013年3月—2014年3月行开腹手术后腹腔引流管发生管口渗液的患者218例，将2013年3—9月置管的110例患者分为对照组，将2013年10月—2014年3月置管的108例患者分为观察组，对照组采用传统引流管渗液处理方法，观察组构建并实施整合医学模式，多学科合作，合理选择敷料，改进渗液处理技术，对患者提供个体化的心理咨询。比较两组患者渗液处理时间、换药费用、患者满意度、投诉率和切口感染率。结果观察组患者置管时大量渗液换药时间为（12．56±5．31） min／d，换药费用为（40．45±5.67）元／d；拔管后换药时间为（10．62±2．79）min／d，换药费用为（15．56±5．62）元／d，均低于对照组，差异有统计学意义（t值分别为11．277，9．019，11．715，－19．100；P＜0．05）。观察组患者满意度为100％，对照组为90％；观察组无一例投诉，对照组投诉率为3．6％；观察组引流管处切口感染率为7．4％，对照组为26．4％；两组比较差异均有统计学意义（χ2值分别为11．374，5．546，13．896；P＜0．05）。结论整合医学模式下的引流管管口渗液处理方法简单经济有效，医护患均获益，值得临床推广应用。
목적：탐토정합의학모식하복강인류관관구삼액처리방법개진적효과。방법선취2013년3월—2014년3월행개복수술후복강인류관발생관구삼액적환자218례，장2013년3—9월치관적110례환자분위대조조，장2013년10월—2014년3월치관적108례환자분위관찰조，대조조채용전통인류관삼액처리방법，관찰조구건병실시정합의학모식，다학과합작，합리선택부료，개진삼액처리기술，대환자제공개체화적심리자순。비교량조환자삼액처리시간、환약비용、환자만의도、투소솔화절구감염솔。결과관찰조환자치관시대량삼액환약시간위（12．56±5．31） min／d，환약비용위（40．45±5.67）원／d；발관후환약시간위（10．62±2．79）min／d，환약비용위（15．56±5．62）원／d，균저우대조조，차이유통계학의의（t치분별위11．277，9．019，11．715，－19．100；P＜0．05）。관찰조환자만의도위100％，대조조위90％；관찰조무일례투소，대조조투소솔위3．6％；관찰조인류관처절구감염솔위7．4％，대조조위26．4％；량조비교차이균유통계학의의（χ2치분별위11．374，5．546，13．896；P＜0．05）。결론정합의학모식하적인류관관구삼액처리방법간단경제유효，의호환균획익，치득림상추엄응용。
Objective To explore the application of integrated medical model on drainage tube orifice seepage of peritoneal cavity.Methods A total of 110 patients, who hospitalized from March to September 2013, were divided into control group received traditional method to cope with tube seepage of peritoneal cavity. While 108 patients during October 2013 to March 2014 underwent integrated medical model ( including multidisciplinary collaboration, suitable dressing, improvement of seepage, personal psychological consultation) as experimental group.Results The time of dressing change and the cost were (12.56 ±5.31) min/d and (40.45 ±5.67) Yuan/d intubated and decreased to (10.62 ±2.79) min/d and (15.56 ±5.62) Yuan/d extubated in the experimental group.All those data were lower than those in the control group with statistical difference (t=11.277,9.019,11.715, -19.100,respectively; P <0.05).The investigated data in the experimental group compared with those in the control group showed as bellows:the rates of satisfaction (100%vs 90%), complaint rate (0% vs 3.6%), and wound infection rate (7.4% vs 26.4%) with statistical difference (χ2 =11.374,5.546,13.896, respectively;P<0.05).Conclusions The integrated medical model is an effective and economic method to cope with drainage tube seepage of peritoneal cavity, benefits doctors, nurses and patients, and is worth of clinical promotion.