Effect of PDCA circulation management on pain, psychology and prognosis of patients with thoracic aortic aneurysm in the perioperative period_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Wenjing ,  ZHANG Chunzhi , LI Qian , LI Xiaoyuan , HAN Yuanyuan , WANG Dawei

Department of Cardiothoracic Surgery, First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, P.R.China;

Corresponding author：

ZHANG Chunzhi, Email: zhangcz999xwk@163.com

Keywords：

Thoracic aortic aneurysm; PDCA circulation; nursing; psychologic status; pain

DOI：

10.7507/1007-4848.201811008

Video：

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Objective To investigate the effect of PDCA circulation management on pain, psychology and prognosis of patients with thoracic aortic aneurysm in the perioperative period.Methods The clinical data of seventy-six patients with thoracic aortic aneurysm who received perioperative nursing based on PDCA circulation management from April 2016 to March 2017 were retrospective analyzed and these patients were selected as the study group, including 44 males, 32 females, aged 23–65 (47.27±5.87) years. At the same time, 72 patients with thoracic aortic aneurysm who received routine perioperative nursing from April 2015 to March 2016 were selected as the control group, including 41 males, 31 females, aged 24–67 (48.30±5.26) years. The nursing effects of the two groups were compared and analyzed.Results The operation time (t=11.342, P<0.05) and hospitalization time (t=5.986, P<0.05) of the study group were significantly shorter than those of the control group. The visual analogue scale (VAS) scores of the two groups had no significant difference before nursing (t=0.914, P=0.361), but the VAS scores in the study group after nursing were obviously lower than those in the control group (t=5.475, P<0.05). The self-rating depression scale (SDS, t=1.026, P=0.307) and self-rating anxiety scale (SAS) scores (t=7.866, P<0.05) of the two groups had no significant difference before nursing, while the SDS (t=7.657, P<0.05) and SAS (t=7.866, P<0.05) scores in the study group after nursing were obviously lower than those in the control group. The incidence of adverse reactions in the study group was significantly lower than that in the control group (χ²=4.292, P=0.038).Conclusion PDCA circulation management used in patients with thoracic aortic aneurysm in the perioperative period can effectively relieve patients' pain, depression and anxiety, reduce the incidence of adverse reactions, and the prognosis is good.

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7.	黄震华. 胸主动脉瘤和胸主动脉夹层治疗进展. 中国新药与临床杂志, 2016, 35(2): 122-127.
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11.	宗行万之助. 疼痛的估价——用特殊的视觉模拟评分法作参考 (VAS). 疼痛学杂志, 1994, 2(4): 153.
12.	Rodriguez-Morales AJ, Ocampo-Serna S, Meneses-Quintero OM, et al. Pression and anxiety screening using Zung Self-Rating Scales (SDS/SAS) among patients with post-Chikungunya chronic inflammatory rheumatism: a comparative study of a 2-year follow-up cohort in La Virginia, Risaralda, Colombia. Int J Infect Dis, 2018, 73: 197.
13.	Soliman H, El-Ganainy MN, Darweesh RM, et al. Short term outcome of thoracic endovascular aortic repair in patients with thoracic aortic diseases. Egypt Heart J, 2018, 70(2): 89-94.
14.	陈桂蓉, 符代雪, 邱琴. 结构式心理护理对行介入栓塞术治疗颅内动脉瘤患者疾病不确定感和预后的影响. 中国健康心理学杂志, 2018, 26(9): 1341-1345.
15.	陈芬芬, 潘聪云, 冯艳文, 等. PDCA 循环护理干预对重症监护室转普通病房患者预后的影响. 国际护理学杂志, 2017, 36(15): 2021-2025.
16.	张新. PDCA 循环管理在降低危重症患儿医源性皮肤损伤的效果观察. 中国妇幼健康研究, 2016, 27(2): 25-26.
17.	王冉冉, 韩猛, 陆晓静, 等. PDCA 循环对脑梗死长期卧床患者负性情绪的影响. 中国健康心理学杂志, 2018, 26(12): 1795-1798.
18.	Chen T, Crozier JA. Endovascular repair of thoracic aortic pathologies: postoperative nursing implications. J Vasc Nurs, 2014, 32(2): 63-69.

1. 黄震华. 胸主动脉瘤诊断和治疗进展. 中国新药与临床杂志, 2015, 34(3): 180-183.
2. Alsawas M, Zaiem F, Larrea-Mantilla L, et al. Effectiveness of surgical interventions for thoracic aortic aneurysms: A systematic review and meta-analysis. J Vasc Surg, 2017, 66(4): 1258-1268.
3. McClure RS, Brogly SB, Lajkosz K, et al. Epidemiology and management of thoracic aortic dissections and thoracic aortic aneurysms in Ontario, Canada: A population-based study. J Thorac Cardiovasc Surg, 2018, 155(6): 2254-2264.
4. Wang GJ, Jackson BM, Foley PJ, et al. National trends in admissions, repair, and mortality for thoracic aortic aneurysm and type B dissection in the national inpatient sample. J Vasc Surg, 2018, 67(6): 1649-1658.
5. Canaud L, Morishita K, Gandet T, et al. Homemade fenestrated stent-graft for thoracic endovascular aortic repair of zone 2 aortic lesions. J Thorac Cardiovasc Surg, 2018, 155(2): 488-493.
6. 黄建华, 王伟, 刘睿. 复杂胸主动脉病变的腔内治疗策略. 中国普通外科杂志, 2017, 26(6): 675-679.
7. 黄震华. 胸主动脉瘤和胸主动脉夹层治疗进展. 中国新药与临床杂志, 2016, 35(2): 122-127.
8. 卢惠敏, 张雷, 张甦明, 等. 去分支技术治疗胸腹主动脉瘤患者的围术期护理. 解放军护理杂志, 2015, 32(19): 45-48.
9. 冯培芳, 郑毅, 郑艺方, 等. 胸腹主动脉瘤腔内修复术围手术期的护理干预. 血管与腔内血管外科杂志, 2017, 3(3): 819-821, 824.
10. Prashar A. Adopting PDCA (Plan-Do-Check-Act) cycle for energy optimization in energy-intensive SMEs. J Clean Prod, 2017, 145(1): 277-293.
11. 宗行万之助. 疼痛的估价——用特殊的视觉模拟评分法作参考 (VAS). 疼痛学杂志, 1994, 2(4): 153.
12. Rodriguez-Morales AJ, Ocampo-Serna S, Meneses-Quintero OM, et al. Pression and anxiety screening using Zung Self-Rating Scales (SDS/SAS) among patients with post-Chikungunya chronic inflammatory rheumatism: a comparative study of a 2-year follow-up cohort in La Virginia, Risaralda, Colombia. Int J Infect Dis, 2018, 73: 197.
13. Soliman H, El-Ganainy MN, Darweesh RM, et al. Short term outcome of thoracic endovascular aortic repair in patients with thoracic aortic diseases. Egypt Heart J, 2018, 70(2): 89-94.
14. 陈桂蓉, 符代雪, 邱琴. 结构式心理护理对行介入栓塞术治疗颅内动脉瘤患者疾病不确定感和预后的影响. 中国健康心理学杂志, 2018, 26(9): 1341-1345.
15. 陈芬芬, 潘聪云, 冯艳文, 等. PDCA 循环护理干预对重症监护室转普通病房患者预后的影响. 国际护理学杂志, 2017, 36(15): 2021-2025.
16. 张新. PDCA 循环管理在降低危重症患儿医源性皮肤损伤的效果观察. 中国妇幼健康研究, 2016, 27(2): 25-26.
17. 王冉冉, 韩猛, 陆晓静, 等. PDCA 循环对脑梗死长期卧床患者负性情绪的影响. 中国健康心理学杂志, 2018, 26(12): 1795-1798.
18. Chen T, Crozier JA. Endovascular repair of thoracic aortic pathologies: postoperative nursing implications. J Vasc Nurs, 2014, 32(2): 63-69.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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