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RESUMEN Fundamento: el dolor es uno de los factores que más afecta dentro del proceso de recuperación, al influir en la evolución satisfactoria del paciente, el mismo produce sufrimiento físico y mental, trastornos del sueño, efectos cardiovasculares, respiratorios y retraso en la movilización; al ser el personal de enfermería el encargado del cuidado y el responsable de identificar los factores que ponen en riesgo la salud. Objetivo: evaluar el dolor posquirúrgico y la aplicación de terapias complementarias por el personal de enfermería. Métodos: se realizó un estudio longitudinal de enfoque cuantitativo, en los pacientes atendidos en el centro quirúrgico del Hospital General Santo Domingo, de Santo Domingo de los Tsáchilas de enero a febrero de 2018. El universo de estudio estuvo constituido por 91 pacientes sujetos a cirugía ambulatoria. Resultados: de los 91 pacientes evaluados, 34 de ellos para un 37,4 % refirieron dolor en el posquirúrgico, de estos el 23,5 % corresponden a ocho personas del género masculino y 26 para un 76,5 % son femenino. El rango de intensidad del dolor que más prevaleció fue el leve en 22 pacientes. De los cuales 10 manifestaron no sentir dolor después de la aplicación de terapias complementarias, mientras que 10 pacientes se mantuvieron en el mismo rango pero con menor intensidad y los dos restantes no presentaron mejoría. Conclusiones: se evidenció un buen manejo del dolor por parte del personal de enfermería, se demostró que la utilización de las terapias complementarias fue favorable, puesto que los pacientes manifestaron alivio, donde el frío local fue el que mayor aceptación y beneficios mostró.
ABSTRACT Background: pain is one of the factors that mostly affects the process of recuperation by influencing the progress of the patient. Pain produces physical and mental suffering, sleep disorders, effects on the cardiovascular and respiratory systems and delays in movement. As nursing personnel are responsible for the care of patients, it is their responsibility to identify factors that put patients' health at risk. Objective: to evaluate post-surgical pain and application of complementary therapies by the nursing personnel. Methods: a longitudinal-cuantitative study was done among patients attended at the surgical ward of the Hospital General Santo Domingo of Santo Domingo de los Tsáchilas from January to February 2018. The universe to be studied consisted of 91 patients subjected to outpatient surgery. Results: out of 91 patients evaluated, 34 patients or 37.4% referred post-surgical pain, 23.5% or 8 patients were male and 26 or 76.5% were female. The intensity range of pain that prevailed the most was mild which was reported by 22 patients. Out of those 22 patients, 10 patients manifested not having felt any pain after the application of complementary therapy, while 10 patients maintained the same range of pain but with minor intensity and 2 patients did not present any improvement at all. Conclusion: good management of pain was shown by the nursing staff through the use of complementary therapies that was found to be favorable as patients reported pain relief. Application of local cold showed the most acceptance and proved to be the most beneficial amongst patients.
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Objective To observe the clinic effects of mirabilite- bag navel nursing in gastrointestinal dysfunction patients after surgery for colon cancer. Methods During Janurary 2013 to Janurary 2016, 80 hospitalized patients with gastrointestinal dysfunction after surgery for colon cancer were randomly allocated to the observation group and the control group, with 40 cases in each group. On the basis of routine nursing, the patients in the control group accepted traditional abdominal bandage nursing, patients in the observation group accepted mirabilite-bag navel nursing. Time to recovery of bowel sound and anal exhaust within 72 hours after surgery, main symptoms within 14 days after surgery such as abdominal pain, abdominal distention, loss of appetite and inflammatory marker C-react protein were observed. Results Within 72 hours after surgery: time to recovery of bowel sound and anal exhaust in the observation group were (26.2±3.3) h and (39.1±8.6) h, respectively, they were significantly shorter than the control group (35.6±6.7) h and ( 65.7±10.9) h, respectively (t=9.42, 11.67, P＜0.01). And there was a higher total effective rate of 90.0% (36/40) in the observation group compared with the total effective rate of 52.5% (21/40) in the control group (χ2=12.14, P＜0.01).Within 14 days after surgery: the total effective rats of improving main symptoms such as abdominal pain, abdominal distention and loss of appetite in the observation group were 90.0%(36/40), 95.0%(38/40), 90.0%(36/40), respectively, all of which were superior to those of the control group, 52.5% (21/40), 40.0% (16/40), 50.0% (20/40), respectively, χ2=12.14, 16.82, 12.75, P＜0.01). Under the nursing interventions, patients′ CRP level in both group were lessened, in the observation group, from (76.91 ± 7.23) mg/L before the intervention to (19.73±5.68)mg/L after the intervention (t=28.43, P<0.05); in the control group, from (77.12±8.09) mg/L before the intervention to (60.33 ± 6.21) mg/L after the intervention (t=6.79, P<0.05). The difference between the two groups also showed statistical significance (t=23.085, P<0.05). Conclusion Mirabilite-bag navel nursing can promote the recovery of gastrointestinal function, lessen inflammatory reaction, improve the main symptoms in patients after surgery of colon cancer.
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Objective:To assess the advantages and nursing experience of foley catheter for nephrostomy tube after minimally invasive percutaneous nephrolithotomy (mPCNL).Methods:From October 2015 to April 2016,the clinical data of 137 patients,who were diagnosed with upper urinary tract calculi and need to perform mPCNL,were collected and randomized into 2 groups:a foley catheter group (research group,n=69) and a normal nephrostomy tube group (control group,n=68).The patients in research group used foley catheter for nephrostomy tube,while those in the control group used normal nephrostomy tube.Bleeding volume,the days of bleeding,pipes shedding and pain degree were compared,and the experience of the nursing process was summarized.Results:The bleeding volume,the days of bleeding in the research group were significantly lower than those in the control group (both P＜0.01).The pipes shedding rate in the research group were lower than that in the control group (P＜0.05).There was no significant difference in postoperative pain scores between the 2 groups (P＞0.05).There was no other complications and discomfortable symptoms in the experimental group.Conclusion:The use of foley catheter for nephrostomy tube after mPCNL is safe,and it can decrease the bleeding volume and pipes shedding rate.It doesn't increase the patient's postoperative pain and can reduce the difficulty and risk for postoperative nursing.