循证护理实践在减少冠脉搭桥手术患者尿管拔除相关并发症中的应用  

Application of evidence based nursing practice in reducing the urinary catheter extraction related complications in coronary artery bypass surgery patients

作　　者：陈林[1] 任香娣[2] 郑静[1] 

机构地区：[1]山东大学附属省立医院心外ICU,济南250021 [2]山东大学附属省立医院新生儿科,济南250021

出　　处：《中华现代护理杂志》2018年第2期130-137,共8页Chinese Journal of Modern Nursing

摘　　要：目的 探讨减少冠脉搭桥手术患者尿管拔除相关并发症的循证护理实践,并了解循证护理实践的应用效果.方法 采用方便抽样法,选择2015年9月—2016年6月山东省某综合性三甲医院心外科行非体外循环冠脉搭桥手术的160例患者为研究对象,按照前后对照研究分为对照组84例和观察组76例.对照组采用传统教科书所述的常规拔管方法,观察组采用循证护理实践方法拔除尿管.观察两组患者尿管拔除时的疼痛指数、拔管后首次排尿时间、拔管后并发症情况（有无血尿、排尿困难、尿潴留、尿失禁）.结果 观察组患者拔管时的疼痛指数为（1.61±1.19）,低于对照组的（4.52±1.04）,差异有统计学意义（t=58.264,P〈0.05）.观察组患者拔管后的首次排尿时间（3.39±1.49） h,短于对照组的（4.79±6.72） h,差异有统计学意义（t=2.620,P〈0.05）.观察组拔管后排尿困难、拔管后尿潴留的发生率均为0,均低于对照组（7.14%、8.33%）,差异有统计学意义（χ2值分别为0.029、0.014;P〈0.05）.拔管后观察组血尿和尿失禁发生率分别为1.32%、0,对照组为3.57%、0,两组比较差异无统计学意义（P〉0.05）.结论 循证护理有利于探索减少冠脉搭桥手术患者尿管拔除相关并发症的方法和策略,对提高临床护理水平具有重要意义.Objective To explore the application of evidence based nursing practice in reducing the urinary catheter extraction related complications in coronary artery bypass surgery patients and its application effects. Methods A total of 160 patients who underwent coronary artery bypass surgery from September 2015 to June 2016 in Cardiosurgery Department of a Class Ⅲ Grade A hospital in Shandong Province were selected as research objects by convenience sampling method, and divided into control group （n=84） and observation group （n=76）. The control group received conventional extubation method, and the observation group adopted evidence-based nursing practice to remove catheter. Pain scores after extubation, the first micturition time after extubation and complications after extubation （including hematuria, dysuria, urinary retention and urinary incontinence） were observed between two groups. Results The extubation pain score of the observation group was （1.61±1.19）, which was lower than that of the control group （4.52±1.04）, with statistical significance （t=58.264,P〈0.05）. The first micturition time after extubation was （3.39±1.49） hours, which was shorter than that of the control group （4.79±6.72） hours, with statistical significance （t=2.620,P〈0.05）. In the observation group, the incidences of dysuria and urine retention were 0, and those in the control group were 7.14% and 8.33% respectively, and the differences were statistically significant （χ2=0.029,0.014;P〈 0.05）. There was no significant difference in the incidence of hematuria （observation group 1.32% vs. control group 3.57%） and urinary incontinence （observation group 0 vs. control group 0） after extubation between the two groups （P〉0.05）. Conclusions Evidence based nursing is helpful to explore the methods and strategies of reducing complications related to catheter removal in patients undergoing coronary artery bypass graft surgery, which is of great significance to improve the level of clinica

关 键 词：导尿管插入术 冠脉搭桥手术 尿管拔除 循证护理 并发症 

分 类 号：R-03[医药卫生] R473.6