目的 探讨风险护理结合加速康复外科护理在神经外科重症患者围手术期护理中的应用效果.方法 回顾性分析2021 年3 月至2022 年3 月于江苏省射阳县人民医院神经外科接受救治的80 例重症患者的一般资料,根据干预方式的不同将患者分为对照组(41 例,加速康复外科护理)和观察组(39 例,风险护理结合加速康复外科护理),并对比2 组患者的临床效果.结果 与对照组相比,观察组的术中出血量更少,手术时间、导尿管留置时间、手术后完全转醒时间和住院时间均更短(P均<0.05).观察组在出院时的血清总蛋白、白蛋白、血红蛋白、总胆固醇及甘油三酯水平均优于对照组(P均<0.05),在干预期间的风险事件和并发症总发生率均低于对照组(P均<0.05).术后7d和出院时,2 组的美国国立卫生院卒中量表(NIHSS)、谵妄评定量表(DRS)评分均较术前降低(P均<0.05),且观察组的NIH-SS、DRS评分均较同期对照组更低(P均<0.05).结论 风险护理结合加速康复外科护理可在一定程度上改善神经外科重症患者的营养状况,促进其神经功能和脑功能的恢复,并减少风险事件及并发症的发生.
目的 探讨基于失效模式与效应分析(FMEA)模型的综合性手术室护理在胃肠外科手术患者中的应用.方法 选择2020 年7 月至2021 年7 月在江苏省东台市人民医院行胃肠外科手术的 42 例患者为对照组,实施传统护理;选择2021 年8 月至2022 年8 月在本院行胃肠外科手术的43 例患者为观察组,实施基于FMEA模型的综合性手术室护理模式.找到风险优先指数(RPN)值超过125 分的失效模式,将其作为优先整改的问题,并制定妥善的改进策略.比较2 组的主要失效模式RPN值、手术指标和术后并发症情况.结果 观察组5 个失效模式的RPN值均明显小于对照组,手术用时和住院时间均短于对照组,术后首次排气时间早于对照组,术后并发症总发生率低于对照组(P均<0.05).结论 在胃肠外科手术管理中应用基于FMEA模型的综合性手术室护理模式,可减少手术安全隐患,提高手术效率,减少术后并发症的发生,促进患者术后康复.
目的 分析阶梯式康复护理在脑梗死后肢体偏瘫患者中的应用效果.方法 对2021 年6 月至2023 年3 月江苏大学附属医院神经内科收治的240 例脑梗死后肢体偏瘫患者资料进行回顾性分析,根据入院时间分为对照组(2021 年6 月至2022 年3 月入院,120 例)与观察组(2022 年4 月至2023 年 3 月入院,120 例).观察组采用阶梯式康复护理,对照组采用常规护理.比较2 组的护理效果.结果 观察组脑梗死患者的康复总依从率(92.50%)比对照组(83.33%)更高(P<0.05).护理10 d、护理20 d、出院当天及出院1 个月后,观察组的肢体偏瘫程度评分以及Lovett肌力分级标准评分均优于同期对照组(P均<0.05),且2 组均优于入院第1 天(P均<0.05).结论 阶梯式康复护理不仅能够提高脑梗死肢体偏瘫患者的康复依从性,还能改善其肢体偏瘫恢复程度和肌力水平.
目的 探讨预保温在降低行成人肝移植手术患者术中低体温和预防寒战发生方面的效果.方法 选取2021 年11 月至2022 年10 月于中山大学附属第一医院行肝移植手术的156 例患者作为研究对象,采用随机数字表法将其分入观察组(78 例)和对照组(78 例).对照组实施围手术期常规保温措施,观察组在常规保温措施的基础上实施预保温措施.记录2 组患者在进入手术室时(T0)、麻醉诱导前(T1)、切皮前(T2)、手术开始后10 min(T3)、手术开始后30 min(T4)和手术结束时(T5)的核心体温,并比较2 组患者在围手术期低体温风险评分、术中低体温发生率、术后寒战程度、T0 及拔除气管插管时(T6)的热舒适度.结果 在T0 时间点,2 组间核心体温的差异无统计学意义(P>0.05);在T1、T2、T3、T4 和T5 时间点,观察组的核心体温均高于同期对照组(P均<0.05).观察组的术后寒战程度优于对照组(P<0.05).在T0 及T6 时间点,观察组的热舒适度评分均高于同期对照组(P均<0.05).观察组的术中低体温风险评分为(16.34±3.07)分,低于对照组的(18.02±3.58)分,差异有统计学意义(t =3.146,P =0.002).观察组的低体温发生率为20.51%(16/78),比对照组的41.03%(32/78)低(χ2 =7.704,P =0.006).结论 对成人肝移植手术患者实施预保温护理干预,可有效维持患者术中核心体温的恒定,减少寒战和低体温的发生,并提升其热舒适度.
Objective To investigate the application effect of evidence-based comprehensive nursing combined with early activity scale in the prevention of deep vein thrombosis(DVT)in elderly patients after surgery for gastrointestinal cancer.Methods Ninety elderly patients with gastrointestinal cancer who underwent surgical treatment at Jinan Integrated Traditional Chinese and Western Medicine Hospital from February 2021 to October 2022 were selected as the research subjects.According to the different intervention methods,they were assigned into a control group(45 cases)and an observation group(45 cases).The control group received routine intervention,while the observation group received evidence-based comprehensive nursing combined with intervention of early activity scale.The level of coagulation function,peak and average velocity of lower limb venous flow,quality of life,psychological resilience,incidence of DVT,and nursing satisfaction were compared between the two groups.Results At 14 days after surgery,the level of D-dimer(D-D)in both groups was lower than that at 1 h and 7 days after surgery.The prothrombin time(PT)and activated partial thromboplastin time(APTT)were longer than those at 1 h and 7 days after surgery.The peak and average velocity of lower limb venous flow were faster than those at 1 h and 7 days after surgery.The scores of the Short Form-36 Health Survey(SF-36)and the Connor-Davidson Resilience Scale(CD-RISC)were higher than those at 1 h and 7 days after surgery.The differences within the group were statistically significant(all P<0.05).At 7 and 14 days after surgery,the D-D level in the observation group was lower than that in the control group,and the PT and APTT were longer than those in the control group.The peak and average velocity of lower limb venous flow were faster than those in the control group.The SF-36 and CD-RISC scores were higher than those in the control group.The incidence of DVT in the observation group was lower than that in the control group,and the nursing satisfaction score was higher than that in the control group.The differences between the groups were statistically significant(all P<0.05).Conclusion The combination of evidence-based comprehensive nursing and early activity scale can reduce the incidence of postoperative DVT in elderly patients with gastrointestinal cancer,enhance their coagulation status and lower limb blood flow velocity,improve their quality of life and psychological resilience,and lead to a high level of nursing satisfaction.
