目的 探究临床护理路径(CNP)模式在肝胆管残余结石患者围术期中的应用效果。方法 选取我院85例肝胆管残余结石患者(2018年1月～2021年4月),随机分为CNP组(n=43)、常规组(n=42)。2组均行胆道镜取石术,常规组接受常规护理干预,CNP组于上述基础上联合CNP模式干预。比较2组干预前后疼痛程度、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、肝胆管残余结石健康宣教知识掌握度(注意事项、并发症预防方法、肝胆管残余结石知识、饮食知识)、并发症发生率及护理满意度。结果 干预后CNP组SAS、SDS评分较常规组低(P＜0.05)；术后24h、48h CNP组疼痛程度较常规组轻(P＜0.05)；干预后CNP组注意事项、并发症预防方法、肝胆管残余结石知识及饮食知识评分均较常规组高(P＜0.05)；CNP组并发症总发生率2.33%(1/43)较常规组19.05%(8/42)低(P＜0.05)；CNP组护理满意度97.67%(42/43)较常规组78.57%(33/42)高(P＜0.05)。结论 CNP模式应用于肝胆管残余结石患者围术期可有效改善其心理状态,减轻疼痛感,提升肝胆管残余结石健康宣教知识掌握度,减少并发症发生,提升护理满意度。

Objective To explore the effect of clinical nursing pathway (CNP) model in the perioperative period of patients with residual hepatolithiasis. Methods 85 patients with residual hepatobiliary calculi in our hospital (January 2018 to April 2021) were selected for a prospective randomized parallel controlled study. According to the random number table method, they were divided into group A (n=43) and group B (n= 42). Both groups underwent choledochoscopy, group B received routine nursing intervention, group A received CNP mode nursing intervention on the basis of group B. The scores of Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), complication rate and nursing satisfaction before and after intervention were compared between the two groups. Results After intervention, the SAS and SDS scores of group A were lower than those of group B (P＜0.05); the total incidence of complications in group A was 2.33% (1/43) lower than that of group B 19.05% (8/42) (P＜0.05); The nursing satisfaction degree of group A was 97.67% (42/43) higher than that of group B 78.57% (33/42) (P＜0.05). Conclusion The application of CNP model to patients with residual hepatolithiasis during the perioperative period can effectively improve their mental state, reduce complications, and improve nursing satisfaction.