269例肝胆外科常见危急值报告分析及护理启示  

Common critical values in hepatobiliary surgery and nursing implications:Analysis of 269 cases

作　　者：李伟容 王小兰[1] 史艳华 LI Wei-rong;WANG Xiao-lan;SHI Yan-hua(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院肝胆外科,广州市510630

出　　处：《当代护士（中旬刊）》2020年第7期1-4,共4页Modern Nurse

摘　　要：目的分析肝胆外科临床危急值,为临床工作中提供更高效的护理。方法收集2016年11月—2018年4月暨南大学附属第一医院肝胆外科的检验危急值,分析危急值类型和临床意义。结果本院肝胆外科18个月中共有204名患者发生269例危急值报告,术前发生的主要危急值有血清淀粉酶43例占16.0%,谷丙转氨酶31例占11.5%,谷草转氨酶28例占10.4%,白细胞22例占8.2%,血糖20例占7.4%,总胆红素13例占4.8%。术后发生的主要危急值有肌酸肌酶62例占23.1%,电解质36例占13.3%,其中钾13例占4.8%。术前及未行手术者共117例占43.5%,发生在手术后的共152例占56.5%。结论通过分析肝胆外科术前术后发生常见的危急值,护士在术前护理中应多关注患者的主诉、症状及体征的变化。术后护理中重点做好患者的心理护理、早期的活动及电解质的平衡。减少并发症发生,加速康复的进程。Objective To analyse the critical value(CV)of patients hospitalized in the department of hepatobiliary surgery and to provide more efficient nursing in clinic.Methods Medical CV records of patients in the department of hepatobiliary surgery in the First Affiliated Hospital of Jinan University between November 2016 and April 2018 were retrospectively collected to analyze the CV types and clinical significance.Results A total of 269 CV were reported in 204 patients in the 18-month period.The main CV before operation were serum activase 43 cases(16.0%),alanine aminotransferase 31 cases(11.5%),aspartate aminotransferase 28 cases(10.4%),white blood cells 22 cases(8.2%),blood glucose 20 cases(7.4%),and total bilirubin 13 cases(4.8%).The main postoperative CV were craniocerebral muscle activity 62 cases(23.1%),electrolytes 36 cases(13.3%),and potassium 13 cases(4.8%).117 patients were before and have not been operated,accounting for 43.5%,and a total of 152 cases occurred after surgery,accounting for 56.5%.Conclusion By analyzing the common CV before and after hepatobiliary surgery,nurses should pay more attention to the patients’complaints,symptoms and signs in preoperative care.Postoperative care should focus on the patient’s psychological care,early activities and electrolyte balance to reduce the incidence of complications and accelerate the process of rehabilitation.

关 键 词：危急值 肝胆外科 护理 治疗 

分 类 号：R473.6[医药卫生—护理学]