个体化围手术期护理在心脏瓣膜置换术患者中的应用研究  

Application of Individualized Perioperative Nursing in Patients Undergoing Cardiac Valve Replacement

作　　者：张瑜 祁佩聪 李梦蝶 ZHANG Yu;QI Peicong;LI Mengdie(Department of Cardiology,Fuwai Central China Cardiovascular Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]阜外华中心血管病医院心外科,河南郑州450000

出　　处：《华南国防医学杂志》2022年第11期922-925,共4页Military Medical Journal of South China

基　　金：河南省医学科技攻关计划项目(LHGJ20200108,SB201902032)。

摘　　要：目的探讨个体化围手术期护理在心脏瓣膜置换术患者中的效果。方法选取作者医院2018-04/2020-06月85例拟行心脏瓣膜置换术患者为研究对象,随机分为对照组(n=43)和观察组(n=42)。对照组给予心脏瓣膜置换术围手术期常规护理,观察组另给予个体化围手术期护理。对比两组围手术期指标、血清炎症因子水平、生活活动能力、生活质量及术后并发症。结果观察组重症加强护理病房(intensive care unit,ICU)监护时间、血流动力学稳定时间、住院时间、住院费用,均明显低于对照组(P均<0.05)。术后1周,观察组肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)、白细胞介素6(interleukin 6,IL-6)与对照组比较明显降低(P均<0.05)。干预后1个月,观察组日常生活活动能力(activities of daily living,ADL)、生活质量评分(quality of life,QOL)与对照组比较明显升高(P均<0.05)。两组低血压、心律失常、腹胀、切口感染、肺部感染等并发症发生率比较无统计学差异(P>0.05)。结论个体化围手术期护理能够明显提升患者围手术期指标、ADL与QOL,降低患者炎症因子水平,对患者并发症发生率无显著影响。Objective To explore the effects of individualized perioperative nursing in patients undergoing cardiac valve replacement surgery.Methods A total of 85 patients undergoing heart valve replacement surgery were taken as the research objects from April 2018 to June 2020 in author′s hospital.They were randomly divided into control group(n=43)and observation group(n=42).The control group was given routine nursing during the perioperative period of heart valve replacement,and the observation group was given individualized perioperative nursing;the perioperative indicators,serum inflammatory factor levels,life activity capability,quality of life and postoperative complications were compared between the two groups.Results The length of intensive care unit(ICU)stay,the hemodynamic stability time,the length of hospitalization and the cost of hospitalization in the observation group were significantly lower than those in the control group(all P<0.05).One week after the operation,tumor necrosis factor alpha(TNF-α)and interleukin 6(IL-6)in the observation group were significantly lower than those in the control group(all P<0.05).One month after intervention,the activities of daily living(ADL)and quality of life(QOL)of the observation group were significantly higher than those of the control group(all P<0.05).there was no significant difference in the incidence of hypotension,arrhythmia,abdominal distension,incision infection,lung infection and other complications between the two groups(P>0.05).Conclusion Individualized perioperative nursing can significantly improve perioperative indicators,ADL and QOL,and decrease the level of inflammatory factors in patients and the incidence of complications was not significantly affected.

关 键 词：主动脉瓣膜置换术 个体化围手术期护理 炎症因子 日常生活活动能力 生活质量 并发症 

分 类 号：R473.6[医药卫生—护理学]