目标导向护理在Stanford A型主动脉夹层术后的应用效果  

Effects of Goal-Oriented Care in Postoperative Patients with Stanford A Aortic Dissection

作　　者：王永婷[1] 朱永慧[2] 马梦丹 李晓召[1] 郭敏[2] WANG Yongting;ZHU Yonghui;MA Mengdan;LI Xiaozhao;GUO Min(Cardiac Surgical Intensive Care Unit,Henan Provincial Chest Hospital,Zhengzhou 450003,China;Nursing Department,Henan Provincial Chest Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省胸科医院心血管外科重症监护病房,河南郑州450003 [2]河南省胸科医院护理部,河南郑州450003

出　　处：《河南医学研究》2023年第2期364-369,共6页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200227)。

摘　　要：目的探讨目标导向护理在Stanford A型主动脉夹层患者术后重症救治及监护中的应用效果。方法选取2020年8月1日至2021年7月31日诊断为Stanford A型主动脉夹层成功实施急诊手术后入住心血管外科重症监护室(CSICU)的121例患者作为研究对象,按照入院先后顺序分为对照组和观察组。2020年8月1日至2021年1月31日的61例患者为对照组,给予心脏外科术后常规护理;2021年2月1日至2021年7月31日的60例患者为观察组,在常规护理基础上实施目标导向护理。比较两组患者术后机械通气时间、术后并发症发生率及CSICU住院时间。结果对照组机械通气时间和CSICU住院时间均长于观察组,差异有统计学意义(P<0.05);观察组患者谵妄发生率为20.0%,低于对照组(37.7%),差异有统计学意义(P<0.05);两组术后肾衰竭、脑血管意外、恶性心律失常、呼吸机相关性肺炎、应激性溃疡的发生率比较,差异无统计学意义(P>0.05)。结论目标导向护理可有效缩短Stanford A型主动脉夹层患者术后机械通气时间及CSICU住院时间,降低谵妄发生率,促进患者康复。Objective To explore the effect of goal-oriented care in postoperative intensive care and monitoring of patients with Stanford A aortic dissection.Methods A total of 121 patients who were diagnosed with Stanford A aortic dissection and were admitted to the cardiac surgical intensive care unit(CSICU)after successful emergency surgery during August 1,2020 to July 31,2021 were selected in the study.Sixty-one patients in the control group were given routine care after cardiac surgery during August 1,2020 to January 31,2021,and 60 patients in the observation group were given the goal-oriented care on the basis of routine care during February 1,2021 to July 31,2021.The mechanical ventilation time,the incidence of postoperative complications and the duration of CSICU stay were compared between the two groups.Results The mechanical ventilation time and duration of CSICU stay in the control group were longer than those in the observation group,and the difference was statistically significant(P<0.05).The incidence of delirium in the observation group was 20.0%,which was lower than that in the control group(37.7%),and the difference was statistically significant(P<0.05).There were no significant differences in the incidence of kidney failure,cerebrovascular accident,malignant arrhythmia,ventilator-associated pneumonia and stress ulcer(P>0.05).Conclusion Goal-oriented care can effectively reduce the postoperative mechanical ventilation time,the duration of CSICU stay and the incidence of delirium in patients with Stanford A aortic dissection in CSICU,and promote the postoperative recovery of the patients.

关 键 词：目标导向护理 Stanford A型主动脉夹层 机械通气 术后并发症 住院时间 

分 类 号：R473.6[医药卫生—护理学]