Department of Surgery, She County People's Hospital, Huangshan, Anhui, China.
Department of Nursing, Huangshan Shoukang Hospital, Huangshan, Anhui, China.
Medicine (Baltimore). 2024 Sep 13;103(37):e39682. doi: 10.1097/MD.0000000000039682.
This study aims to assess nursing methods' effects on ureteral stone patients post-Pneumatic ballistic lithotripsy with double J-tube placement. Through comparing interventions' impact on recovery, complications, and overall quality of life, the study aims to establish a more effective nursing protocol for this patient group. This study investigates ureteral stone patients who underwent PL and subsequent double J-tube placement between January 2020 and October 2023. A total of 100 eligible subjects (n = 100), meeting the inclusion and exclusion criteria, were divided into an intervention group (n1 = 50) and a control group (n2 = 50) according to different treatments. The control group received routine in-hospital care combined with outpatient follow-up, while the intervention group underwent continuous care using the Omaha system. Nursing effects pre- and post-intervention were assessed using questionnaires, clinical indicators, and the Omaha evaluation system, evaluating aspects such as cognition, behavior, and status in terms of environment, psychosocial aspects, physiology, and health behavior. Additionally, complications during double J-tube placement and pain scores were compared among the patients. Prior to the intervention, no statistically significant differences were observed between the scores of both groups across environmental, psychosocial, physiological, and health behavioral domains. Subsequent to the nursing intervention on the first postoperative day, at discharge, and post-discharge, a statistically significant variance was evident between the groups across these domains (P < .05). Furthermore, the intervention group exhibited notably lower rates of infection, hematuria, and residual or fragmented stones, all significantly lower with a P-value of <.05, compared to the control group. While a reduction in tissue damage and acute kidney injury was observed in the intervention group compared to the control group, this difference did not reach statistical significance. Notably, 92% of patients in the intervention group reported no pain during the nursing intervention, in contrast to only 52% in the control group. Continuity care utilizing the Omaha system demonstrates favorable outcomes in managing double J stent placement post-PL among ureteral stone patients, notably leading to a significant reduction in both pain levels and the incidence of associated complications.
本研究旨在评估经皮肾镜碎石术后留置双 J 管的输尿管结石患者的护理方法的效果。通过比较干预措施对恢复、并发症和整体生活质量的影响,本研究旨在为这组患者建立更有效的护理方案。本研究调查了 2020 年 1 月至 2023 年 10 月期间接受 PL 治疗并随后放置双 J 管的输尿管结石患者。共有 100 名符合纳入和排除标准的合格受试者(n=100),根据不同的治疗方法分为干预组(n1=50)和对照组(n2=50)。对照组接受常规住院护理和门诊随访,而干预组则采用奥马哈系统进行连续护理。使用问卷、临床指标和奥马哈评估系统评估干预前后的护理效果,评估认知、行为和环境状况、社会心理方面、生理和健康行为等方面。此外,还比较了患者在放置双 J 管期间的并发症和疼痛评分。干预前,两组在环境、社会心理、生理和健康行为等方面的评分均无统计学差异。在术后第一天、出院时和出院后进行护理干预后,两组在这些方面的评分均有统计学差异(P<.05)。此外,干预组的感染、血尿和残留或碎裂结石的发生率明显低于对照组,差异有统计学意义(P<.05)。与对照组相比,干预组的组织损伤和急性肾损伤有所减少,但差异无统计学意义。值得注意的是,干预组有 92%的患者在护理干预期间报告没有疼痛,而对照组只有 52%的患者报告没有疼痛。与对照组相比,奥马哈系统的连续性护理在经皮肾镜碎石术后留置双 J 管的输尿管结石患者管理中表现出良好的效果,显著降低了疼痛水平和相关并发症的发生率。