护理干预对腹部手术后患者硬膜外自控镇痛不良反应的影响  

Impact of nursing intervention on the adverse reaction of PCEA after abdominal operation

作　　者：李容华[1] 马吉安[1] 张贵清[1] 李文碧[1] 于力萍 

机构地区：[1]四川省达州市第二人民医院,635000

出　　处：《中国实用护理杂志》2009年第6期26-28,共3页Chinese Journal of Practical Nursing

摘　　要：目的探讨护理干预对硬膜外自控镇痛（PCEA）不良反应的影响。方法选择2006—2007年进行腹部手术后行PCEA的患者258例，采用前后对照的方法，2006年1-12月未实施护理干预的126例患者为对照组，2007年1—12月实施护理干预的132例患者为实验组。对照组主要由麻醉师管理，护士只进行常规的护理指导，实验组除常规护理指导外，同时实施系统、规范的护理干预。即进行心理干预、认知干预、行为干预、严密观察、及时发现不良反应并早期处理。观察2组患者发生尿潴留、恶心呕吐、腹胀、皮肤压痕、导管脱落、皮肤瘙痒、下肢麻木、呼吸抑制等PCEA不良反应的发生率并进行比较。结果实验组恶心呕吐、腹胀、排尿障碍、导管脱落、皮肤压痕等PCEA不良反应的发生率明显低于对照组，差异显著。结论实施护理干预能降低腹部手术后PCEA的不良反应，减轻患者的痛苦，促进术后功能恢复和机体康复。Objective To explore impact of nursing intervention on the adverse reaction of patient con- trol epidural analgesia （PCEA） after abdominal operation. Methods 258 patients underwent PCEA after abdominal operation were selected from 2006 to 2007. The clinical data of 126 patients without nursing intervention were analyzed as the control group admitted to our hospital from January to December, 2006 and compared with those of 132 patients receiving nursing intervention as the experimental group from January to December, 2007. The control group was managed by the anesthetists and nurses only conducted routine nursing instruction, while the experimental group was given systematic and normative nursing intervention besides routine nursing instructions, including psychological intervention, behavioral intervention, close observation, of discovery of adverse reaction in time and giving early disposal. The incidence of adverse reaction of PCEA of the two groups such as urinary retention, nausea and vomiting, abdominal distension, skin indentation, catheter shedding, skin itching, numbness of lower limbs, respiratory depression was observed. Results Compared with the contwl group, the incidence of adverse reactions of PCEA in the experimental group such as urinary retention, nausea and vomiting, abdominal distension, skin indentation, catheter shedding was significantly lower. Conclusions The implementation of nursing intervention can reduce the adverse reaction of PCEA after abdominal operation, alleviate the suffering of patients, and promote functional recovery and the body rehabilitation.

关 键 词：PCEA 护理干预 不良反应 

分 类 号：R473.6[医药卫生—护理学]