老年鼻咽喉部疾病患者行胃癌根治术后选择性留置胃管的循证护理实践  

Effects of evidence-based nursing practice on selective nasogastric tube after radical resection of old people with nasal and throat diseases

作　　者：高辉[1] 秦发伟[2] 

机构地区：[1]山东大学附属省立医院麻醉科,济南250014 [2]山东大学附属省立医院推拿科,济南250014

出　　处：《中华现代护理杂志》2016年第3期332-338,共7页Chinese Journal of Modern Nursing

摘　　要：目的 应用循证护理探讨老年鼻、咽喉部疾病患者在胃癌根治术后选择性留置胃管的可行性及胃管留置期间的个性化护理.方法 采用循证护理,搜索国内外相关护理文献,评价老年鼻、咽喉部疾病患者胃癌根治术后选择性留置胃管的证据,应用证据制定护理计划.选取具有鼻、咽喉部疾病的胃癌根治术老年患者82例,随机分为观察组42例和对照组40例,对照组给予术后常规留置胃管护理,观察组给予循证护理.记录观察组患者的置管率,比较两组患者的脱管率、肛门首次排气或排便时间、首次进流质饮食时间及术后腹胀、恶心、呕吐不适、吻合口瘘、肺部感染等的发生率,比较两组术后口鼻、咽喉不适反应发生率.结果 观察组患者有4例因病情需要给予留置胃管,减少了患者术后的鼻、咽喉部不适,降低了留置胃管者的脱管率;观察组患者肛门首次排气（3.0±0.3）d、排便（4.2±0.3）d、首次进食流质饮食时间（4.6±0.9）d,均较对照组提前,差异有统计学意义（t值分别为-4.99,-6.28,-5.06;P〈0.05）;对照组患者发生恶心6例,呕吐5例,均高于观察组,差异有统计学意义（χ2值分别为1.07,5.60;P〈0.05）.结论 循证护理实践应用于老年鼻、咽喉部疾病患者在胃癌根治术后可不常规留置胃管,且可以提高患者术后鼻、咽喉的舒适程度,加快胃肠道的功能恢复.Objective To apply the evidence-based nursing to discuss the feasibility of nose, pharynx and throat disease in aged patients after radical gastric cancer selective indwelling gastric tube and the individualized nursing care during the phase. Methods We used evidence-based nursing care, searched related literature at home and abroad, then assessed the evidences of elderly patients with nose, pharynx and throat diseases who accepted radical resection of gastric cancer after selective indwelling gastric tube, then we applied the evidences and evidence of the nursing care plans. A total of 82 elderly patients with nose, pharynx and throat diseases were treated as the research objects. The subjects were divided into experimental group （42 cases） and control group （40 cases） by the random number table. We investigated the basis of selectively indwelling gastric tube and time of the elderly patients with nose, pharynx and throat disease of radical gastric cancer. We observed the indwelling gastric tube rate of the experimental group, the extubation rate, anal exhaust time, for the first time into the liquid or defecation time, postoperative abdominal distention, nausea, vomiting unwell, anastomotic fistula, pulmonary infection etc. between the two groups. We compared symptom improvement rate of nose, pharynx and throat by their subjective evaluation. Results There were 4 patients indwelled gastric tube in the experimental group patients. In the experimental group, the postoperative nasal, throat discomfort were improved, the rate of removal of tube indwelling gastric tube were reduced, compared with the control group （P〈0. 05）;anal exhaust, defecate, the first liquid meal time in the experimental was lower than that in the control group （P 〈0. 05）. The nausea rate, vomiting rate of two groups were statistically significant （P〈0. 05）. Conclusions Application of evidence-based nursing practice in elderly patients with nose, pharynx and throat disease of radical gastric made our known that patien

关 键 词：循证护理 老年人 鼻、咽喉疾病 胃癌根治术 选择性胃管留置 

分 类 号：R473.73[医药卫生—护理学] R-03[医药卫生—临床医学]