围术期预见性护理对老年气管插管患者的应激反应及苏醒质量的影响  

Effect of perioperative predictive nursing on stress response and recovery quality of elderly patients with tracheal intubation

作　　者：郑秋艳[1] ZHENG Qiu-yan(Operating Room,Tangshan People's Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]唐山市人民医院手术室,河北唐山063000

出　　处：《川北医学院学报》2020年第4期728-730,734,共4页Journal of North Sichuan Medical College

基　　金：河北医学科学研究重点课题计划(20181226)。

摘　　要：目的:探讨围术期预见性护理对老年气管插管患者的应激反应及苏醒质量的影响。方法:选择行外科手术并气管插管的84例老年患者为研究对象,按简单随机分组法分为观察组和对照组,每组各42例。对照组给予围术期常规护理,观察组给予围术期预见性护理干预。比较两组患者气管插管时间、苏醒时间、ICU住院时间、插管期间应激反应、苏醒质量及并发症发生率。结果:观察组患者气管插管时间、苏醒时间、ICU住院时间[(24.75±7.05)min、(47.36±11.24)min、(2.24±0.71)d]均明显短于对照组患者[(35.94±8.42)min、(72.51±13.18)min、(4.91±1.15)d],差异有统计学意义(P<0.05)。观察组患者插管期间C反应蛋白、去甲肾上腺素及肾上腺素水平[(52.28±8.54)ng/L、(157.36±9.51)pmol/L、(102.41±8.68)pmol/L]均低于对照组患者[(95.42±10.29)ng/L、(176.84±10.47)pmol/L、(140.15±9.52)pmol/L],差异有统计学意义(P<0.05)。观察组患者苏醒期分级明显轻于对照组,差异有统计学意义(P<0.05)。观察组患者并发症率(7.14%)低于对照组患者(30.95%),差异有统计学意义(P<0.05)。结论:围术期预见性护理干预有利于缩短老年气管插管患者的插管时间、苏醒老年、ICU住院时间,减轻插管期间应激反应,提高苏醒质量,减少非计划性拔管及并发症,具有较高的借鉴价值。Objective:To explore the effect of perioperative predictive nursing on stress response and recovery quality of elderly patients with tracheal intubation,and to provide reference for clinical nursing.Methods:84 elderly patients with endotracheal intubation were selected as the study subjects.According to the simple random grouping method,they were randomly divided into observation group(42 cases)and control group(42 cases).The control group was given perioperative routine nursing,while the observation group was given perioperative predictive nursing intervention.The intubation time,recovery time,ICU hospitalization time,stress response during intubation,recovery quality,and complication rate were compared between the two groups.Results:The time of tracheal intubation,awakening and ICU hospitalization in the observation group(24.75±7.05 min,47.36±11.24min,2.24±0.71d)were significantly shorter than those in the control group(35.94±8.42 min,72.51±13.18 min,4.91±1.15 d),the differences were statistically significant(P<0.05).The levels of C-reactive protein,norepinephrine and epinephrine in the observation group(52.28±8.54 ng/L,157.36±9.51 pmol/L,102.41±8.68 pmol/L)were significantly lower than those in the control group(95.42±10.29 ng/L,176.84±10.47 pmol/L,140.15±9.52 pmol/L),the differences were statistically significant(P<0.05).The grade of patients in the observation group was significantly lighter than that in the control group,the difference was statistically significant(P<0.05).The complication rate in the observation group(7.14%)were lower than those in the control group(30.95%),the difference was statistically significant(P<0.05).Conclusion:Perioperative predictive nursing intervention is helpful to shorten the intubation time,recovery time,ICU hospitalization time of elderly patients with tracheal intubation,alleviate stress reaction during intubation,improve the quality of recovery,and reduce unplanned extubation and complications,which has high reference value.

关 键 词：气管插管 老年 围术期 预见性护理 应激反应 苏醒质量 

分 类 号：R614[医药卫生—麻醉学]