保护性约束对脑损伤躁动患者意外拔管的预防效果  

Application of Protective Constraint in Preventing Accidental Extubation in Brain Injury Patients with Restlessness

作　　者：封苏平[1] 郑红[1] 姜国英[1] 叶霞[1] 

机构地区：[1]衢州市人民医院神经外科,浙江衢州324000

出　　处：《解放军护理杂志》2010年第5期343-344,347,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨保护性约束措施在预防脑损伤躁动患者意外拔管中的效果。方法将神经外科2007年6月至2009年5月收治的120例脑损伤躁动患者分为3组,每组40例。A组采用肢体约束,B组采用肢体约束加手指约束,C组在B组基础上输液置管部位加局部保护。比较3组患者头部引流管、吸氧管、胃管、输液管、导尿管的意外拔管情况。结果(1)B、C组患者的累计意外拔管数明显少于A组,差异有统计学意义(P<0.01);(2)3组患者头部引流管的意外拔管数差异无统计学意义(P>0.05);(3)B、C组患者的吸氧管、胃管、输液管、导尿管的意外拔管数均少于A组,差异有统计学意义(P<0.05);(4)C组患者的输液管意外拔管数少于B组,差异有统计学意义(P<0.01)。结论采用肢体加手指约束联合输液置管部位局部保护的约束措施对预防脑损伤躁动患者的意外拔管有最好的预防效果。Objective To investigate the effects of protective constraint measures in preventing accidental extubation in brain injury patients with restlessness. Methods A total of 120 brain injury patients with restless from June,2007 to May,2009 in neurosurgery department were equally randomized into Group A treated with limbs constraints, group B with limbs constraints plus two fingers bound and Group C with plus partial protection in the infusion catheter site based on with limbs constraints plus two fingers bound. A comparison was condu cted on the accidental extubations, such as head drainage tube, oxygen tube, gastric t：ube,infusion tube, urethral catheter among the three groups. Results （1） The total number of accidental extubation was significantly less in Group B and Group C than in group A（P〈0. 01）; （2）No significant differences were observed on the number of accidental extubation of head drainage tube among the three groups（P〉0.05） ;（3）The number of accidental extubation of oxygen tube, gastric tube, infusion tube, urethral catheter were significantly less in group B and group C than in group A（P〈0.05） ; （4）The number of accidental extubation of infusion tube in group C was significantly less than in groupB（P〈0.01）. Conclusion Rational use of protect restraint measures on the prevention of accidents extubation in brain injury patients with restlessness have important clinical significance.

关 键 词：保护性约束 脑损伤 躁动 预防 意外拔管 

分 类 号：R651.1[医药卫生—外科学]