Li Rui-Xuan, Liu Jing, Jin Ping, Ye Xiu-Qin, Xu Song
Department of Urology, General Hospital of Eastern Theater Command, Nanjing, Jiangsu 210002, China.
Center of Reproductive Medicine，The First Affiliated Hospital of Ningbo University， Ningbo， Zhejiang 315010， China.
Zhonghua Nan Ke Xue. 2024 Feb;30(2):157-162.
To study the effect of cluster nursing care based on 10S continuous quality improvement (CQI) on the incidence of postoperative delirium in patients with BPH.
This study included 96 BPH patients undergoing transurethral resection of the prostate (TURP) in our department from August 2021 to February 2023. We randomly divided the patients into two groups of equal number to receive routine postoperative nursing care (the control group) and postoperative cluster nursing care based on the 10S DQI mode (the observation group), respectively. We recorded and compared the delirium scores of the patients at 2, 6, 12 and 24 hours after operation, their status of recovery, scores on Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and quality of life (QOL), and incidence of complications between the two groups.
Compared with the controls, the patients in the observation group showed significantly lower delirium scores at 2 h (12.72±3.54 vs 10.65±2.87, P<0.05), 6 h (20.17±4.92 vs 14.19±4.64, P<0.01), 12 h (16.82±4.24 vs 10.69±3.18, P<0.01) and 24 h (13.61±2.86 vs 9.13±2.12, P<0.01) after operation, and shorter time to ambulation (［3.65±1.41］ vs ［2.84±0.83］ d, P<0.01) and time of postoperative catheterization (［6.28±1.65］ vs ［4.28±1.14］ d, P<0.01), bladder irrigation (［3.41±1.08］ vs ［2.25±0.71］ d, P<0.01) and hospitalization (［10.33±2.41］ vs ［7.82±2.06］ d, P<0.01). No statistically significant differences were observed between the two groups in either the SAS and SDS scores (P >0.05) or the QOL scores before operation (P >0.05), but the former two were dramatically decreased (P<0.01) while the latter one increased in the observation group postoperatively (P<0.01). Postoperative complications included delirium, bladder spasm, urethral pain, and secondary bleeding, with a significantly lower total incidence rate in the observation than in the control group (12.50% vs 52.08%, P<0.01).
Cluster nursing care based on 10S CQI can promote the postoperative recovery of BPH patients, improve their psychological status and quality of life, and reduce the incidence of delirium and complications.
探讨基于10S持续质量改进（CQI）的集束化护理对良性前列腺增生症（BPH）患者术后谵妄发生率的影响。
选取2021年8月至2023年2月在我科行前列腺经尿道切除术（TURP）的96例BPH患者，将其随机分为对照组和观察组，每组48例。对照组给予常规术后护理，观察组采用基于10S CQI模式的术后集束化护理。记录并比较两组患者术后2、6、12及24小时的谵妄评分、康复情况、焦虑自评量表（SAS）、抑郁自评量表（SDS）评分及生活质量（QOL）评分，以及两组并发症的发生率。
观察组患者术后2小时（12.72±3.54比10.65±2.87，P<0.05）、6小时（20.17±4.92比14.19±4.64，P<0.01）、12小时（16.82±4.24比10.69±3.18，P<0.01）及24小时（13.61±2.86比9.13±2.12，P<0.01）的谵妄评分均显著低于对照组，且下床活动时间（［3.65±1.41］比［2.84±0.83］天，P<0.01）、术后留置导尿管时间（［6.28±1.65］比［4.28±1.14］天，P<0.01）、膀胱冲洗时间（［3.41±1.08］比［2.25±0.71］天，P<0.01）及住院时间（［10.33±2.41］比［7.82±2.06］天，P<0.01）均短于对照组。两组患者术前SAS、SDS评分及QOL评分比较，差异均无统计学意义（P>0.05），但观察组术后SAS、SDS评分显著降低（P<0.01），QOL评分显著升高（P<0.01）。术后并发症包括谵妄、膀胱痉挛、尿道疼痛及继发性出血，观察组并发症总发生率显著低于对照组（12.50%比52.08%，P<0.01）。
基于10S CQI的集束化护理可促进BPH患者术后康复，改善其心理状态和生活质量，降低谵妄及并发症的发生率。
