基于循证构建的床旁盲插鼻肠管护理方案在重型颅脑损伤患者中应用效果分析  

Effect analysis on evidence-based construction of bedside blind nasointestinal intubation nursing program in patients with severe craniocerebral diseases

作　　者：叶凯丽 陈晓青[1] 杨建静[1] 诸葛启钏[1] Ye Kaili;Chen Xiaoqing;Yang Jianjing;Zhuge Qichuan(Department of Neurosurgery,the First Afiliated Hospilal of Wenzhou Medical Universily,Wenzhou 325006,Zhejiang,China)

机构地区：[1]温州医科大学附属第一医院神经外科,浙江温州325006

出　　处：《中国中西医结合急救杂志》2020年第5期595-598,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省自然科学基金(LQ20H090005)。

摘　　要：目的 探讨基于循证构建床旁盲插鼻肠管护理方案在重型颅脑损伤患者中的应用效果.方法 回顾性分析2019年1月至2020年1月在温州医科大学附属第一医院就诊的100例重型颅脑损伤患者的临床资料,按护理方案将患者分为基于循证的护理组和常规护理组,每组50例.常规护理组对重型颅脑损伤患者床旁盲插鼻肠管进行常规护理;基于循证的护理组按照循证护理方法进行干预.记录两组患者一次性置管成功率和堵管、脱管、导管移位等并发症发生情况以及达到全量胃肠营养时间;自制调查问卷,评估两组患者的护理满意度.结果 基于循证的护理组一次性置管成功率显著高于常规护理组〔88.00%(44/50)比64.00%(32/50),P<0.05〕,基于循证的护理组堵管率、脱管率、导管移位率均较常规护理组明显降低〔堵管率:2.00%(1/50)比14.00%(7/50),脱管率:6.00%(3/50)比22.00%(11/50),导管移位率:2.00%(1/50)比16.00%(8/50),均P<0.05〕,达到全量胃肠营养时间较常规护理组明显缩短(d:4.83±0.50比5.35±0.52,P<0.05);基于循证的护理组护理技术、护理效果、护理态度等满意度评分均显著高于常规护理组〔护理技术(分):2.54±0.40比1.38±0.73,护理效果(分):2.39±0.54比1.76±0.63,护理态度(分):2.41±0.55比1.93±0.82,均P<0.05〕.基于循证的护理组并发症发生率显著低于常规护理组〔8.0%(4/50)比30.0%(15/50),P<0.05〕.结论 基于循证构建床旁盲插鼻肠管护理方案能显著提高重型颅脑损伤患者的护理效果和护理满意度,降低术后并发症发生率,具有较高的临床应用价值.Objective To explore the application effect of nursing program of bedside blind nasointestinal intubation based on evidence in patients with severe craniocerebral injury.Methods The clinical data of 100 patients with severe craniocerebral injury admitted 1o the First Afiliated Hospital of Wenzhou Medical University from January 2019 to January 2020 were retrospectively analyzed.According to diference in nursing programs,the patients were divided into an evidence-based nursing group and a routine nursing group,with 50 cases in each group.The routine nursing group received routine mursing of bedside blind insertion of nasointestinal tube in patients with severe craniocerebral injury,while in the evidence-based mursing group,the intervention was carried out in accord with the evidence-based nursing method.The success rate of once intubation and complications such as plugging,decannulation,displacement of catheter and the time of reaching total gastrointestinal nutrition were recorded in the two groups.The self-designed questionnaire was used to evaluate the patients'satisfaction rate toward the nursing care in the two groups.Results The success rate of one--time catheterization in evidence-based nursing group was signifcantly higher than that in routine nursing group[88.00%(44/50)vs.64.00%(32/50),P<0.05].In evidence-based nursing group,the catheter plugging rate,decannulation(removal)rate and displacement rate were significanly lower than those in routine nursing group[plugging rate:2.00%(1/50)vs.14.00%(7/50),decannulation rate:6.00%(3/50)vs.22.00%(11/50),catheter displacement rate:2.00%(1/50)vs.16.00%(8/50),all P<0.05],and the time reaching total gastrointestinal nutrition in evidence-based nursing group was significantly shorter than that in routine nursing group(days:4.83±0.50 vs.5.35±0.52,P<0.05).The patients'satisfaction scores toward nursing technology,nursing ffct,nursing atitude in evidence-based nursing group were obviously higher than those in routine nuring group[nursing technology(points):2.54±0.40 vs

关 键 词：循证护理 颅脑损伤 重型 床旁盲插鼻肠管 

分 类 号：R47[医药卫生—护理学]