术前体验式护理联合麻醉苏醒护理对减轻HoLEP术患者全麻苏醒期躁动的效果分析

蒋秀娟; 王宇; 杨方兰

doi:10.16766/j.cnki.issn.1674-4152.002259

术前体验式护理联合麻醉苏醒护理对减轻HoLEP术患者全麻苏醒期躁动的效果分析

doi: 10.16766/j.cnki.issn.1674-4152.002259

蒋秀娟^{1, 2},
王宇^3, ,,
杨方兰²

1.
成都市第二人民医院手术室，四川成都 610052
2.
三六三医院手术室，四川成都 610041
3.
三六三医院泌尿外科，四川成都 610041

基金项目:

四川省卫健委科研课题项目 18PJ457

详细信息

通讯作者:
王宇, E-mail: 15882487431@139.com

中图分类号: R473.6 R614
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- 文章访问数: 192
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- 被引次数: 0
出版历程
- 收稿日期: 2020-04-27
- 网络出版日期: 2022-03-02

Effect analysis of preoperative experiential nursing combined with anesthesia recovery nursing to reduce emergence agitation in patients undergoing HoLEP

JIANG Xiu-juan^{1, 2},
WANG Yu^{3
, ,},
YANG Fang-lan²

1.
Department of Operating Room, Chengdu Second People's Hospital, Chengdu, Sichuan 610052, China

摘要

摘要: 目的探讨术前体验式护理联合麻醉苏醒护理对减轻经尿道前列腺钬激光剜除(HoLEP)术患者全麻苏醒期躁动的临床效果。方法纳入三六三医院2018年11月—2019年11月实施HoLEP术的患者108例，采用随机数字表法分为观察组和对照组各54例，观察组采用术前体验式护理联合麻醉苏醒护理，对照组采用传统护理。比较2组患者进入麻醉复苏室30 min时心率、血压、躁动发生率、非计划再次手术率、术后1 d尿道舒适度及护理满意度。结果观察组进入麻醉复苏室30min时心率[(78.41±6.23) 次/min vs. (89.35±7.91)次/min, t=7.613, P=0.018]、血压[收缩压(132.17±11.36) mm Hg(1 mm Hg=0.133 kPa) vs. (148.56±10.25) mm Hg, t=10.385, P=0.013；舒张压(86.34±7.83) mm Hg vs. (98.62±10.16) mm Hg, t=8.352, P=0.016]与对照组相比较，差异有统计学意义(均P＜0.05)。观察组全麻苏醒期躁动发生率(12.96%)明显低于对照组(35.19%，P=0.025)。观察组非计划再次手术率(1.85%)低于对照组(5.56%，P=0.219)。观察组术后1 d尿道舒适度(85.19%)显著高于对照组(70.37%，P=0.031)。观察组护理满意度(96.30%)明显高于对照组(87.04%，P=0.047)。结论对于无留置尿管病史需全麻行HoLEP术患者，术前体验式护理联合麻醉苏醒护理能减轻全麻苏醒期躁动，减缓尿道不适感，提高护理满意度，值得推广应用。
- 体验式护理 /
- 麻醉苏醒护理 /
- 经尿道前列腺钬激光剜除术 /
- 全麻苏醒期躁动
Abstract: Objective To investigate clinical effect of preoperative experiential nursing combined with anesthesia recovery nursing to reduce emergence agitation in patients undergoing holmium laser enucleation of the prostate (HoLEP). Methods Totally 108 patients undergoing HoLEP in 363 hospital from November 2018 to November 2019 were randomized into experimental group and control group by random number method, 54 cases each group. The experimental group received preoperative experiential nursing combined with anesthesia recovery nursing, and the control group received routine nursing care. The blood pressure and heart rate 30 minute after entering anesthesia recovery room, incidence of agitation, incidence of unplanned reoperation, urethra comfort postoperative 1 d and nursing satisfaction were compared between the two groups. Results The blood pressure [systolic pressure (132.17±11.36) mm Hg(1 mm Hg=0.133 kPa) vs. (148.56±10.25) mm Hg, t=10.385, P=0.013; diastolic pressure (86.34±7.83) mm Hg vs. (98.62±10.16) mm Hg, t=8.352, P=0.016] and heart rate [(78.41±6.23) times/min vs. (89.35±7.91) times/min, t=7.613, P=0.018] 30 minute after entering anesthesia recovery room in the experimental group was significantly lower than the control group (all P < 0.05). The incidence of agitation was significantly less in the experimental group than that in the control group (12.96% vs. 35.19%, P=0.025). The incidence of unplanned reoperation was lower in the experimental group than the control group (1.85% vs. 5.56%, P=0.219). The urethra comfort postoperative 1 d was significantly higher in the experimental group than the control group (85.19% vs. 70.37%, P=0.031). The nursing satisfaction was significantly higher in the experimental group than the control group (96.30% vs. 87.04%, P=0.047). Conclusion For no-catheter history patients undergoing HoLEP, preoperative experiential nursing combined with anesthesia recovery nursing can reduce emergence agitation, relieve urethral irritation and increase nursing satisfaction, it is worth clinical spreading.
- Experiential nursing /
- Anesthesia recovery nursing /
- Transurethral holmium laser enucleation of prostate /
- Emergence agitation

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表 1 2组患者全麻苏醒期心率和血压比较(x±s)

组别	例数	心率(次/min)	收缩压(mm Hg)	舒张压(mm Hg)
观察组	54	78.41±6.23	132.17±11.36	86.34±7.83
对照组	54	89.35±7.91	148.56±10.25	98.62±10.16
t值		7.613	10.385	8.352
P值		0.018	0.013	0.016
注：1 mm Hg=0.133 kPa。

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表 2 2组患者全麻苏醒期躁动程度及躁动发生率比较[例(%)]

组别	例数	≤4分	5分	6分	7分	躁动发生
观察组	54	47(87.04)	4(7.41)	2(3.70)	1(1.85)	7(12.96)
对照组	54	35(64.81)	9(16.67)	6(11.11)	4(7.41)	19(35.19)
注：2组躁动程度比较，Z=2.722, P=0.007；2组躁动发生率比较，χ²=7.295，P=0.007。

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表 3 2组患者术后1 d尿道舒适度比较[例(%)]

组别	例数	0级	Ⅰ级	Ⅱ级	Ⅲ级	尿道舒适度
观察组	54	20(37.04)	28(51.85)	4(7.41)	2(3.70)	48(88.89)
对照组	54	15(27.78)	23(42.59)	13(24.07)	3(5.56)	38(70.37)
注：2组尿道舒适度比较，χ²=5.708，P=0.017。

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表 4 2组患者护理满意度比较[例(%)]

组别	例数	非常满意	基本满意	一般满意	不满意	总满意度
观察组	54	28(51.85)	20(37.04)	4(7.41)	2(3.70)	52(96.30)
对照组	54	22(40.74)	14(25.93)	9(16.67)	9(16.67)	45(83.33)
注：2组满意情况比较，Z=2.039，P=0.041；2组总满意度比较，χ²=4.960，P=0.026。

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