老年腹部手术前预防肺部感染的护理措施  

Preoperative nursing measures for preventing pulmonary infection prevention in elderly patients undergoing abdominal operation

作　　者：王雪蕾[1] 吴雪静 胖艳敏 马晴[1] 

机构地区：[1]唐山市玉田县医院外科,河北唐山064100 [2]唐山市玉田县计生医院,河北唐山064100

出　　处：《检验医学与临床》2015年第20期3082-3083,3086,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨对腹部手术老年患者采用加强术前呼吸道护理措施的临床效果。方法将260例老年腹部手术患者随机分为研究组与对照组,每组各130例。对照组采取传统术前护理措施控制患者原发内科及呼吸系统疾病、嘱患者术前戒烟及常规术前健康教育。研究组于对照组基础上采用加强术前呼吸道护理措施,包括肺功能训练、有效咳嗽及吞咽功能训练。评价手术后患者72h排痰量、血氧饱和度(SpO2)及肺部感染发生率。结果研究组患者术后72h排痰量明显高于对照组(P<0.01);对照组术后SpO2>95%的患者占78.46%,研究组为97.69%,差异具有统计学意义(P<0.01);对照组术后感染性肺炎发病率为7.69%,其中吸入性肺炎4例,发病率3.08%;研究组术后感染性肺炎发病率为2.31%,未出现吸入性肺炎患者,发病率较对照组均明显降低,差异有统计学意义(P<0.05)。结论对腹部手术老年患者采用加强术前呼吸道护理措施,有利于患者术后早期排痰及肺功能恢复。Objective To investigate the clinical effect of intensively preoperative airway nursing measures in elderly patients undergoing abdominal operation.Methods 260 patients undergoing abdominal operation were randomly divided into the study group and the control group,130 cases in each group.The control group adopted the conventionally preoperative nursing measures for controlling the primary internal medicine and respiratory diseases of the patients,instructing patients to quit smoking before operation and preoperative routine health education.The study group adopted the intensively preoperative airway nursing measures,including lung function training,effective cough and swallowing function training on the basis of the control group.The postoperative 72 hsputum expectoration volume,blood oxygen saturation（SpO2）and the incidence of pulmonary infection of the patients were evaluated.Results The 72 hsputum expectoration volume of the study group after operation was significant higher than that of the control group（P〈0.01）.The patients with postoperative SpO2 〉95% in the control group accounted for78.46%,while which in the study group accounted for 97.69%,the difference was statistically significant（P〈0.01）.The postoperative incidence rate of pulmonary infection in the control group were 7.69%,including 4cases of aspiration pneumonia with the incidence rate was 3.08%;while which in the study group was 2.31% and no cases of aspiration pneumonia occurred,the differences were statistically significant（P〈0.05）.Conclusion Adopting the intensively preoperative airway nursing measures on elderly patients undergoing abdominal operation is conducive to early postoperative sputum expectoration and lung function recovery.

关 键 词：老年患者 腹部手术 术前护理 肺部感染 

分 类 号：R473.6[医药卫生—护理学]