机构地区:[1]福建医科大学附属第一医院神经内科,福建福州350005
出 处:《中华危重病急救医学》2019年第3期355-358,共4页Chinese Critical Care Medicine
摘 要:目的为心电监护患者设计一种新型改良病号服,并观察其临床应用效果。方法在传统病号服的基础上,克服现有改良型心电监护服的缺点,设计一种新型的改良病号服,并取得国家实用新型专利。选择2015年1月至2018年6月在福建医科大学附属第一医院神经内科住院且意识清醒的心电监护患者408例,根据入院顺序编号,按随机数字表法分为3组,进行3种病号服穿戴效果比较。使用传统病号服133例;使用改良型心电监护服139例,根据文献报道的方法,在传统病号服基础上移除口袋,于心电监护贴电极片的位置分别制作一个直径5 cm的圆洞,用于穿过导联线和电极片;使用新型改良病号服136例,鉴于传统病号服不便于心电监护且容易刺激胸腹部皮肤,现有改良型心电监护服不易操作、粘贴电极片部位不易判断且导联线凌乱等问题,新型改良病号服仍以传统病号服为基础,将现有改良型心电监护服的3个圆洞制作成长约12 cm的切口以便于心电监护导联线与电极片穿过,并在两侧靠近肩膀位置各增加1条固定带或使用简易贴以整理固定导联线。记录3组患者对病号服舒适度的自我评价、护士安装与拆除心电监护操作时间、患者皮肤过敏率及导联线损坏情况,并进行比较。结果与传统病号服和改良型心电监护服两组比较,新型改良病号服组患者舒适度更高〔无不适的比例:11.0%(15/136)比0%(0/133)、5.8%(8/139),重度不适的比例:0%(0/136)比4.5%(6/133)、0.7%(1/139),均P<0.05〕,护士安装与拆除心电监护时间明显缩短〔安装时间(s):69.12±16.47比96.74±3.89、88.24±9.83,拆除时间(s):50.24±4.54比75.76±4.98、66.54±7.86,均P<0.01〕,且患者皮肤过敏发生率〔3.7%(5/136)比15.8%(21/133)、8.6%(12/139)〕和导联线失绝缘率〔2.9%(4/136)比15.8%(21/133)、7.9%(11/139)〕均明显降低(均P<0.05)。结论心电监护患者使用新型改良病号服能增加其舒适度,Objective To design a new modified sick clothes for electrocardiogram (ECG) monitoring, and to observe its clinical application effect. Methods In order to overcome the shortcomings of the existing modified ECG monitoring clothes, a new type of modified sick clothes was designed on the basis of the traditional sick clothes, and a national utility model patent was obtained. 408 conscious patients with ECG monitoring admitted to department of neurology of the First Affiliated Hospital of Fujian Medical University from January 2015 to June 2018 were enrolled, and they were randomly divided into three groups according to the order of admission for comparing the wearing effect of three kinds of sick clothes. 133 patients dressed traditional clothes, while 139 patients dressed modified ECG monitoring clothes. According to the method reported in the literature, the pockets were removed on the basis of the traditional patient clothes, and a circular hole 5 cm in diameter was made at the position of the electrodes for ECG monitoring, which was used to pass through the lead wire and the electrodes. 136 patients dressed the new modified sick clothes. In view of the inconvenience of ECG monitoring and stimulation of patients' thoracic and abdominal skin by traditional sick clothes, the existing modified ECG monitoring clothes were not easy to operate, the location of electrodes sticking was not easy to judge and the lead line was messy, the new modified sick clothes were still based on the traditional ones. The three circular holes of the existing modified ECG monitoring clothes were made into incisions about 12 cm in length to facilitate the ECG monitoring lead line and electrodes sticking. A compression band or a simple patch was added to each side near the shoulder for tidying up the fixed lead. The self-evaluation of patient's comfort, the operation time of ECG monitoring by nurses, skin allergy rate and lead damage rate were recorded and compared among the three groups. Results Compared with the traditional sick clothes
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