肝切除术后早期拔除胃管的循证护理  

Evidence-based nursing on the extubation early of stomach tube after hepatectomy

作　　者：邹琴[1] 罗艳丽[2] 李晓玲[1] 赵延慧[1] 刘双双[2] 

机构地区：[1]四川大学华西医院/华西护理学院,成都610041 [2]四川大学华西医院肝脏外科

出　　处：《中华现代护理杂志》2015年第21期2519-2522,共4页Chinese Journal of Modern Nursing

摘　　要：目的：采用循证的方法为1例肝切除术患者实施术后早期拔除胃管,并评价其临床效果以及对术后康复的影响。方法根据患者病情,按 PICO 原则提出临床问题,全面检索 Ovid-EBM Reviews、Medline、Trip Database、CNKI、万方、维普等数据库,检索时限为1995—2014年,获取关于肝切除术患者术后早期拔出胃管的临床指南、系统评价、随机对照试验、证据摘要和综述等证据,并对获得的证据进行质量评价。结果纳入分析的有系统评价2篇,Meta 分析1篇,随机对照试验3篇,非随机对照试验1篇。肝切除术后早期拔除胃管可降低患者咽部不适感的发生率,促进患者胃肠功能恢复,并且不会增加患者恶心、呕吐、腹胀、肺部感染等并发症的发生率。结合患者的病情及意愿,术后10 h 拔除胃管,患者术后第7天顺利出院。结论肝切除术患者术后早期拔除胃管安全可行,有利于患者术后的早期康复。Objective To utilize evidence-based nursing to extubate stomach tube early for one patients with postoperative hepatectomy, and to evaluate clinical effects and the impact on postoperative rehabilitation.Methods According to patient′ s condition and clinical issues of PICO principle, we retrieve Ovid-EBM Reviews, Medline, Trip Database, CNKI, Wanfang Database, VIP Database and so on from 1995 to 2014 to acquire the clinical guideline, system evaluation, random control trail, evidence abstract and literature review and other evidences, and assess the quality of acquired evidences. Results There were 2 system evaluation, 3 random control trail, 1 non-random control trail. The extubation of stomach tube early after hepatectomy could minimize the discomfort incidences of pharynx, promote the recovery of gastrointestinal function, and could not increase the complication incidences of patients′ nausea, vomiting, ventosity, pulmonary infections and so on. Combined with patient′s condition and intention, the stomach tube could be extubate 10 hrs after hepatectomy and patients could discharged 7 d after operation. Conclusions The extubation of stomach tube early after hepatectomy is a safe and feasible method which is beneficial for patients′ recovery.

关 键 词：肝切除术 胃管 手术后并发症 循证护理 

分 类 号：R473.6[医药卫生—护理学]