神经外科手术患者术后早期下床活动的影响因素分析  

Influencing factors of early ambulation after surgery in neurosurgery patients

作　　者：张晓蕾[1] 王军[1] Zhang Xiaolei;Wang Jun(Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100054,China)

机构地区：[1]首都医科大学宣武医院神经外科,北京100054

出　　处：《中华现代护理杂志》2021年第2期227-231,共5页Chinese Journal of Modern Nursing

摘　　要：目的调查神经外科手术患者术后早期下床活动情况,并分析相关影响因素。方法采用分层多级抽样法选取2018年1—5月北京某三级甲等医院神经外科收治的220例行神经外科手术治疗患者,采取自制调查表调查其术后早期下床活动情况,依据是否早期下床活动分为早期下床活动组与未早期下床活动组,比较两组患者临床资料(性别、年龄、经济收入、居住地、婚姻状况、术中失血量、手术类型、疾病种类、携带监护仪、绷带拆除、疼痛、负性情绪、留置尿管、肌力问题、引流管、头晕与呕吐等),并采用Logistic回归分析探讨早期下床活动的影响因素。结果220例患者中,120例(54.55%)患者术后未执行早期下床活动,100例(45.45%)患者执行术后早期下床活动。单因素分析显示,两组患者术中失血量、手术类型、携带监护仪、未拆绷带、留置尿管、肌力问题、引流管、头晕与呕吐比较差异有统计学意义(P<0.05);Logistic回归分析显示,手术类型、未拆绷带、留置尿管、肌力问题、引流管、头晕与呕吐是神经外科手术患者术后早期下床活动的独立影响因素(P<0.05)。结论神经外科手术患者术后早期下床活动执行情况不理想,急诊手术、未拆绷带、留置尿管、存在肌力问题、有引流管、发生头晕与呕吐为影响患者开展早期下床活动的主要独立危险因素,临床护理人员可针对危险因素予以合理干预,以促进患者早期下床,改善预后。Objective To explore the early ambulation after surgery of patients undergoing neurosurgery,and analyze its related influencing factors.Methods From January to May 2018,stratified multilevel sampling was used to select 220 neurosurgery patients who were admitted to the Department of Neurosurgery in a ClassⅢGrade A hospital in Beijing.The self-designed questionnaire was used to investigate the early ambulation after surgery.Patients were divided into early ambulation group and non-early ambulation group based on early ambulation.We compared clinical data(gender,age,economic income,place of residence,marital status,intraoperative blood loss,type of surgery,type of disease,carrying a monitor,bandage removal,pain,negative emotion,indwelling catheters,muscle strength problems,drainage tubes,dizziness and vomiting and so on)of patients between two groups,and used Logistic regression analysis to explore influencing factors of early ambulation.Results Among 220 patients,120(54.55%)patients did not perform early ambulation,and 100 patients(45.45%)performed early ambulation after surgery.Univariate analysis showed that there were statistically significant differences in intraoperative blood loss,type of surgery,monitors,unremoved bandages,indwelling catheters,muscle strength problems,drainage tubes,dizziness and vomiting of patients between two groups(P<0.05).Logistic analysis showed that type of surgery,unremoved bandages,indwelling catheters,muscle strength problems,drainage tubes,dizziness and vomiting were independent influencing factors of early ambulation in patients after neurosurgery(P<0.05).Conclusions The implementation of early ambulation after surgery in neurosurgery patients is not ideal.The main independent risk factors affecting patients'early ambulation include the emergency surgery,unremoved bandages,indwelling catheters,have muscle strength problems,drainage tubes,dizziness and vomiting.Clinical nurses can provide reasonable interventions based on risk factors to promote patients early ambulation and im

关 键 词：神经外科手术 早期下床活动 加速康复外科 相关因素 

分 类 号：R473.6[医药卫生—护理学]