基于循证的气管插管全麻导管拔除管理方案的构建与应用  

Evidence-based protocol for removal of tracheal tube after surgery under general anesthesia

作　　者：王树欣[1] 韩文军[1] 张丽君[1] 

机构地区：[1]上海长海医院麻醉科,上海200433

出　　处：《护理学杂志》2017年第10期41-44,共4页Journal of Nursing Science

摘　　要：目的提高麻醉护士拔管护理的规范性和麻醉护理质量。方法检索数据库,获取临床实践指南、证据汇总、推荐实践、系统评价等证据等级较高的文献,拟定气管导管拔除方案初稿,通过专家会议法对方案进行补充修正,最终确立PACU全麻患者气管导管拔除护理管理方案并应用于102例麻醉苏醒拔管患者,并与应用前的104例患者比较拔管效应。结果方案应用后,拔管后患者的呼吸系统异常情况发生率显著低于应用前,患者报告咽喉痛程度及对PACU有记忆率显著高于应用前(P<0.05,P<0.01);PACU麻醉护士除拔管后严密观察病情外,其余行为明显改善(均P<0.01)。结论以循证为依据构建的PACU全麻患者气管导管拔除护理管理方案切实可行,可以提高临床麻醉护理质量。Objective To standardize removal of tracheal tube by nurse anesthetists and to improve quality of anesthesia care. Methods Electronic databases were searched to retrieve high-quality literatures, including clinical practice guidelines, evidence summary, recommended practice, and systematic review. Then protocol for removal of tracheal tube was developed and revised by expert meetings. Finally, the protocol was implemented in 102 patients during emergence from general anesthesia and effect was compared with 104 patients receiving routine removal of tracheal tube. Results The rate of abnormal respiratory events was significantly de creased, whereas more patients reported laryngeal pain and some memory during emergence after implementation of the protocol （P〈0. 05,P〈0.01）. Nurse anesthetists＇ care behaviors except observation of patients were also significantly improved after use of the protocol （P〈0. 01 for all）. Conclusion Evidence-based protocol for removal of tracheal tube in surgical patients after general anesthesia is feasible and practical to improve quality of anesthesia care.

关 键 词：全身麻醉 气管插管 气管导管 拔管 循证实践 麻醉后复苏 

分 类 号：R472.3[医药卫生—护理学]