目的探讨胸外科患者术后最佳护理模式,达到优质护理服务。方法把180例胸外科手术患者随机分为对照组和实验组,对照组给予常规护理,实验组将自理模式贯穿于常规护理的全过程,在疾病的不同阶段选择不同的护理系统实施护理,两组在拔除胸腔闭式引流管前行肺部CT或胸片检查,对肺不张的程度进行评价,并记录两组拔管的时间,两组在出院前进行满意度调查。结果实验组术后肺不张发生情况低于对照组(P<0.05),拔管时间及住院时间明显缩短(P<0.01),实验组对护理工作的满意度明显高于对照组。结论把Orem自理模式应用到胸外科术后,可减少术后并发症的发生,促进患者身体康复,提高满意度。

Objectives To explore the optimal nursing model for patients of thoracic surgery department,so as to provide high quality service.Methods 180 cases of patients from thoracic surgery department were randomly divided into an experimental group and a control one.The control group was given routine nursing service,while the Orem's self-care model was applied to the control one in the overall course of routine nursing.Corresponding care systems were selected at different stages of disease.Thoracic CT or chest radiographs of the two groups were examined before removing their closed thoracic drainage tubes to evaluate level of pulmonary atelectasis,and the times of the removal were recorded respectively.The patients were investigated about degrees of satisfaction before discharge.Results The experimental group had a lower incidence of pulmonary atelectasis(P<0.05);the times of drainage tube removal and lengths of stay were extended obviously in the control group(P<0.01);patients of the experimental group had higher degrees of satisfaction towards the nursing service they received(98.7 %vs.87.25 %).Conclusions This study suggested that applying the Orem's self-care model to patients of thoracic surgery department would reduce incidence of postoperative complications,speed recovery after surgery and improve satisfactions.