摘要
目的探讨量化评估在老年危重患者气管切开术后管道护理中的应用价值。方法纳入2018年1月至2020年1月住院治疗的老年危重患者108例,均行气管切开术,并于术后给予管道护理。根据随机数字表法分为对照组和观察组各54例。其中对照组行常规护理,观察组根据量化评估结果进行护理。比较2组置管时间、呼吸机使用时间、监测时间与总住院时间;分别在术后第1天、第7天比较2组血氧饱和度(SpO2)、舒张压(DBp)、收缩压(SBp)以及心率(HR)的变化;记录2组并发症发生率,评价2组患者满意度。结果观察组置管时间、呼吸机使用时间、监测时间、总住院时间分别为(20.35±5.37)、(9.65±3.53)、(14.81±3.34)、(31.29±4.87)d,较对照组的(24.91±4.79)、(11.81±4.02)、(16.95±3.99)、(35.97±6.51)d显著缩短,差异有统计学意义(t值为3.153~4.657,P<0.05);对照组术后1周SpO2、DBp、SBp分别为0.9752±0.0183、(79.39±7.41)、(137.46±7.09)mmHg(1 mmHg=0.133 kPa),均高于术前的0.9534±0.0159、(75.45±8.01)、(134.66±6.61)mmHg,差异有统计学意义(t值分别为6.608、2.653、2.123,P<0.05)。观察组术后1周SpO2、DBP、SBP分别为0.9591±0.0172、(76.13±6.94)、(134.56±7.33)mmHg,显著低于对照组,差异有统计学意义(t值为4.711、2.360、2.090,P<0.05)。观察组并发症率为11.11%(6/54),显著低于对照组的25.93%(14/54),差异有统计学意义(χ^(2)值为3.927,P<0.05)。观察组护理满意度总分为(61.52±8.03)分,高于对照组的(52.11±7.99)分,差异有统计学意义(t值为6.104,P<0.05)。结论量化评估能缩短老年危重症气管切开术患者的置管、呼吸机使用、监测与总住院时间,确保术后生命体征稳定,降低并发症率,且能提高患者满意度。
Objective To explore the application value of quantitative assessment in the pipeline nursing after tracheotomy in elderly critical patients.Methods A total of 108 elderly critically ill patients admitted to our hospital from January 2018 to January 2020 were treated with tracheotomy and given plumbing care after surgery.According to the random number table method,it was divided into a control group(54 cases)and an observation group(54 cases).The control group received routine nursing,and the observation group received nursing according to the quantitative evaluation results.The tube placement time,ventilator use time,monitoring time,and total hospitalization time were compared between the two groups.The changes of blood oxygen saturation(SpO2),diastolic blood pressure(DBP),systolic blood pressure(SBP)and heart rate(HR)were compared on the 1st and 7th days after operation.The incidence of complications was recorded and the patients'satisfaction and quality of life were evaluated.Results In the observation group,the catheter placement time,ventilator use time,monitoring time,and total hospital stay were(20.35±5.37)days,(9.65±3.53)days,(14.81±3.34)days and(31.29±4.87)days,respectively,compared with the control group(24.91±4.79)days,(11.81±4.02)days,(16.95±3.99)days,(35.97±6.51)days were significantly shortened(t values were 3.153 to 4.657,P<0.05).SpO2,DBP,and SBP of the control group were 0.9752±0.0183,(79.39±7.41)mmHg(1 mmHg=0.133 kPa)and(137.46±7.09)mmHg,respectively,at 1 week after operation,which were all higher than the preoperative 0.9534±0.0159 and(75.45±8.01)mmHg,(134.66±6.61)mmHg(t values were 6.608,2.653,2.123,P<0.05).SpO2,DBP,and SBP in the observation group were 0.9591±0.0172,(76.13±6.94)mmHg,and(134.56±7.33)mmHg,respectively,in the observation group one week after operation,which were significantly lower than those in the control group(t values were 4.711,2.360,2.090,P<0.05).The complication rate in the observation group was 11.11%(6/54),which was significantly lower than the 25.93%(14/54)in the control group(χ^(2)value was 3.927,P<0.05).The total score of nursing satisfaction in the observation group was(61.52±8.03)points,which was higher than the(52.11±7.99)points in the control group(t value was 6.104,P<0.05).Conclusion Quantitative assessment can shorten the tube placement time,ventilator use time,monitoring time and total hospitalization time of elderly patients with critical tracheotomy,ensure stable postoperative vital signs.It can reduce the complication rate and improve the patients'satisfaction.
作者
申艳玲
李海水
李显文
Shen Yanling;Li Haishui;Li Xianwen(Department of Surgical Critical Care Medicine,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国实用护理杂志》
2021年第24期1862-1867,共6页
Chinese Journal of Practical Nursing
关键词
切管切开术
管道护理
量化评估
并发症
护理满意度
Tube incision
Plumbing care
Quantitative evaluation
Complication
Nursing satisfaction
