目的：将NNN链接的护理方法应用于老年腹外疝术后患者，探索其常用的护理诊断、护理结局、护理措施及其链接，并在护理计划的实施过程中，通过动态的护理结局评价，分析护理措施的效果。

方法：采用随机抽样的方法，选取石河子大学普外三科行腹外疝手术的老年患者60例，对患者进行全面评估后，以《护理诊断手册》（第11版）、《护理结局分类》（第3版）、《护理措施分类》（第5版）和《护理诊断、结局与措施》（第2版）为参考依据，确定每位腹外疝患者术后的护理诊断、护理结局、护理措施及其链接，并根据每项指标的护理结局得分情况确定护理措施的效果。采用SPSSl7.0统计软件对全部数据进行分析，统计方法包括统计描述和两个独立样本的非参数检验。

结果：1.老年腹外疝患者术后护理主要涉及11项护理诊断、15项护理结局、27项护理措施和36项NNN链接；

2.使用频率最多的5项护理诊断依次为活动无耐力、组织完整性受损、知识缺乏、慢性疼痛和有摔倒的危险，这些护理诊断的使用频率均超过10% ；

3.使用频率最多的5项护理结局为活动耐力、组织完整性：皮肤和黏膜、离床活动、知识：饮食和疼痛程度，它们的累计频率超过总数的50% ；

4.使用频率最多的8项护理措施分别是：环境管理：舒适、体位、切口护理、环境管理：安全、运动疗法：步行、卫教：医嘱饮食、卫教：医嘱活动∕运动和疼痛管理，它们占总数的54.42% ；

5.使用次数最多的前10位NNN链接分别为：（1）活动无耐力-活动耐力-运动疗法：步行，（2）疼痛-疼痛程度-体位，（3）知识缺乏-知识：饮食-卫教：医嘱饮食，（4）疼痛-疼痛程度-疼痛管理，（5）知识缺乏-知识：治疗方案-卫教：医嘱活动∕运动，（6）知识缺乏-知识：饮食-健康教育，（7）知识缺乏-知识：预防摔倒-卫教：医嘱活动∕运动，（8）有摔倒的危险-预防摔倒行为-环境管理：安全，（9）有摔倒的危险-预防摔倒行为-预防跌倒，（10）知识缺乏-知识：预防摔倒-环境管理，且这些NNN链接的使用次数均在50次以上；

6.在老年腹外疝患者术后第一天与出院当天的NOC平均分比较中，有12项护理结局的得分有显著性差异（P＜0.05），而预防摔倒行为、知识：预防摔倒和体温调节三项护理结局的得分比较没有显著差异（P＞0.05）；

7. 在确定有效护理措施的研究中，除了预防摔倒行为—环境管理：安全、预防摔倒行为—预防跌倒、知识：预防摔倒—卫教：医嘱活动∕运动、知识：预防摔倒—卫教：个体、知识：预防摔倒—环境管理、体温调节—发热治疗和体温调节—体温调节等7项NOC-NIC无显著性差异（P＞0.05）外，其余均有显著性差异（P＜0.05）。

结论：

1.应用NNN链接术语不仅对老年腹外疝术后护理实践进行了科学的总结，也为老年腹外疝护理的研究领域提供了新的知识；

2.应用标准化护理语言描述护理实践活动，可以为其他照护领域提供理论依据。

Objective: The purpose of the study was to identify the most frequently used nursing diagnoses, interventions, outcomes, and linkages, and to evaluate the effectiveness of nursing interventions (NIC) using nursing outcomes (NOC) for elderly patients with abdominal external hernia surgery.

Method: For this study a randomize sample was used. The frequently used NANDA-I, NIC, NOC, and NNN linkages were identified according to the 11^th Handbook Of Nursing Diagnosis, the 3^th Nursing Outcome Classification, the 5^th Nursing Intervention Classification and the 2^th NANDA, NOC and NIC Linkages, the effective interventions were determined through 60 elderly patients with abdominal external hernia surgery who were admitted in hospital from March to December in 2014. Data were analyzed by SPSS17.0. Descriptive Statistics and 2 Independent Nonparametric Tests were used in this study.

Results: 1. 11 nursing diagnoses, 15 nursing outcomes, 27 nursing interventions and 36 NNN linkages were used in the study.

2. The most prevalent nursing diagnoses were Activity Intolerance, Tissue Integrity Impaired, Knowledge Deficit, Chronic Pain and Risk for Falls. These 5 nursing diagnoses was used for more than 10% respectively.

3. The most prevalent nursing outcomes were Activity Tolerance, Tissue Integrity: Skin & Mucous Membranes, Ambulation, Knowledge: Diet, and Pain Level. These 5 nursing outcomes accounted for almost 50% of the nursing outcomes for patients with abdominal external hernia surgery.

4. The most prevalent nursing interventions were Environment Management: Comfort, Positioning, Incision Cite Care, Environmeng Management: Safety, Exercise Therapy: Ambulation, Teaching: Prescribed Diet, Teaching: Prescribed Activity∕Exercise and Pain Management. These 8 nursing interventions accounted for more than 50% of the nursing interventions for patients with abdominal external hernia surgery.

5. The most prevalent 10 NNN linkages were (1) Activity Intolerance-Activity Tolerance- Exercise Therapy: Ambulation, (2) Pain-Pain Level-Positioning, (3) Knowledge Deficit-Knowledge: Diet-Teaching: Prescribed Diet, (4) Pain-Pain Level-Pain Management, (5) Knowledge Deficit-Knowledge: Treatment Regimen-Teaching: Prescribed Activity∕Exercise, (6) Knowledge Deficit-Knowledge: Diet-Health Education, (7) Knowledge Deficit-Knowledge: Fall Prevention-Teaching: Prescribed Activity∕Exercise, (8) Risk for Falls-Fall Prevention Behaviour-Environmeng Management: Safety, (9) Risk for Falls-Fall Prevention Behaviour-Fall Prevention, (10) Knowledge Deficit-Knowledge: Fall Prevention-Environment Management. These linkages were used over 50 times for patients with abdominal external hernia surgery.

6. The scores of 12 nursing outcomes increased significantly（P＜0.05）between the first day after surgery and the discharged. Fall Prevention Behaviour, Knowledge: Fall Prevention and Thermoregualtion did not show statistically significant differences（P＞0.05）.

7. All of the NOC-NIC show statistically significant differences （P＜0.05）, besides Fall Prevention Behaviour-Environmeng Management: Safety, Fall Prevention Behaviour-Fall Prevention, Knowledge: Fall Prevention-Teaching: Prescribed Activity∕Exercise, Knowledge: Fall Prevention-Teaching: Individual, Knowledge: Fall Prevention-Environmeng Management, Thermoregulation-Fever Treament, Thermoregulation-Temperature Regulation.

Conclusions: 1. The application of NNN linkages standard language for patients with abdominal external hernia surgery in this study not only offer new knowledge to nurses but also provide scope of evidence-based nursing research in abdominal external hernia clinics.

2. Application of standardized nursing language to describe nursing practice can provide a theoretical basis for other care field.