不同护理干预措施预防胸部手术后心肺并发症的研究  

Contrast study of different nursing methods on the heart and pulmonary complications for patients after thoracic operation

作　　者：张娟[1] 王慧[1] 杨慧芳[1] 

机构地区：[1]南京军区福州总医院心胸外科,福建福州350025

出　　处：《护士进修杂志》2008年第4期294-296,共3页Journal of Nurses Training

摘　　要：目的探讨传统拍背咳痰与改进的护理干预排痰方法对胸部手术后心肺并发症的预防、排痰效果及改善呼吸功能的作用。方法在582例胸部手术患者中选择120例,按随机原则分为改进组与对照组,每组各60例,观察两组患者术后发生低氧血症、需纤维支气管镜(纤支镜)介入吸痰、发生室上性心律失常的情况,同时观察并记录两组病例的排痰感受,对排痰前后动脉血气结果进行对比分析。结果两组患者发生低氧血症、肺不张、需纤支镜介入吸痰与发生室上性心律失常的情况,改进组均明显少于对照组(P<0.01);改进组患者在感受舒适方面与对照组比较差异有显著意义(P<0.01);对照组感受到剧痛、能忍受的疼痛、出现恶心感与改进组相比差异有显著意义(P<0.01)。术后48 h的PaO_2、PaCO_2与排痰前即术后6 h比较差异均有显著意义(P<0.01),pH值两者前后均无统计学意义(P>0.05)。但改进组术后48 h与术后6 h的PaO_2、PaCO_2差值与对照组术后48 h与术后6 h的差值相比较,差异有极显著意义。结论改进后的护理干预措施对胸部手术后心肺并发症能够取得理想的预防与治疗效果。Objective To study the preventive effect on pulmonary complications, and to analyze physiological effects and airway clearance of vibration and traditional sputum ejection for patients after thoracic operation. Method 120 patients after thoracic operation were selected and randomly divided into two groups, the contrast group and the experimental group. Hypoxemia, pulmonary atelectasis, supraventricular, Arrhythmias and feeling of the patients Were compared in both groups. The arterial blood gas was also measured at different time as 6 hour and 48 hour of post operation. Result The complications, such as hypoxemia, pulmonary atelectasis and supraventricular Arrhythmias, the cases of sputum ejection by fiber optic bronchoscopy were significantly less in the experimental group. The cases of comfortable feeling in the contrast group was less than that in the experimental group, but cases of pain feeling in the contrast group was more than that in the experimental group （P〈0.01）. There were more improvements of the PaO2 and PaCO2 at 48 hours than at 6 hours for the patients with two methods, but the experimental group improved significantly more than the contrast group. Conclusion The use of improved nursing inter vention was safe, well-tolerated, comfort and effective in preventing pulmonary complications for patients after thoracic operation.

关 键 词：胸部手术 心肺并发症 动脉血气分析 护理干预 

分 类 号：R472[医药卫生—护理学] R473.6[医药卫生—临床医学]