老年痴呆长期鼻饲患者非计划性拔管原因及护理干预措施分析  

Analysis of the causes and nursing interventions of unplanned extubation in elderly dementia patients undergoing long-term nasal feeding

作　　者：欧阳莲 Ouyang Lian(The 921st Hospital of the People's Liberation Army of China,Changsha,Hunan 410022,China)

机构地区：[1]中国人民解放军第921医院,湖南长沙410022

出　　处：《首都食品与医药》2023年第18期117-119,共3页Capital Food Medicine

摘　　要：目的探析老年痴呆长期鼻饲病患非计划性拔管的原因,合理制定护理干预措施。方法回顾性分析2018年1月-2022年12月期间到中国人民解放军第921医院诊治老年痴呆长期鼻饲的病患,共选取60例,分析非计划拔管原因,制定相应护理干预方案。其中,将2018年1月-2020年6月期间接收的30例老年痴呆长期鼻饲病患作为A组,采取常规护理干预。将2020年7月-2022年12月期间接收的30例老年痴呆长期鼻饲病患作为B组,采取综合护理干预。比较两组非计划性拔管发生率、护理满意度。结果分析非计划性拔管原因发现,受精神状态影响的占比最高,即30.00%,其次分别为固定过松占21.67%,翻身、穿衣占16.67%,约束过松占15.00%,体位变化占11.67%,胃管堵塞占5.00%,经比较,差异有统计学意义(P<0.05)。A组非计划性拔管发生率26.67%明显高于B组的3.33%(P<0.05)。A组患者家属满意度为76.67%,低于B组的96.67%(P<0.05)。结论对于老年痴呆长期鼻饲病患,导致非计划性拔管发生的原因较多,如固定过松、精神状态影响、体位变化、约束过松、胃管堵塞、翻身穿衣等,经采取相应的护理干预措施后,非计划性拔管发生率降低,对病患预后改善起重要作用。Objective Exploring the causes of unplanned extubation in elderly dementia patients with long-term nasal feeding,and formulating reasonable nursing intervention measures.Method A retrospective analysis was conducted on 60 long-term nasal feeding patients with elderly dementia who visited our hospital from January 2018 to December 2022.The reasons for unplanned extubation were analyzed,and corresponding nursing intervention plans were developed.Among them,30 long-term nasal feeding patients with elderly dementia who were admitted from January 2018 to June 2020 were selected as Group A and routine nursing interventions were taken.30 long-term nasal feeding patients with elderly dementia received from July 2020 to December 2022 were selected as Group B and comprehensive nursing interventions were taken.Compare the incidence of unplanned extubation and nursing satisfaction between two groups.Results After analyzing the reasons for unplanned extubation,it was found that the proportion affected by mental state was the highest,which was 30.00%.The following factors were loose fixation(21.67%),turning over and dressing(16.67%),loose restraint(15.00%),posture changes(11.67%),and gastric tube blockage(5.00%).After comparison,the differences were statistically significant(P<0.05).The incidence of unplanned extubation in Group A was 26.67%,significantly higher than Group B's 3.33%(P<0.05).The satisfaction rate of family members in Group A was 76.67%,lower than 96.67%in Group B(P<0.05).Conclusion For long-term nasal feeding patients with elderly dementia,there are many reasons for unplanned extubation,such as loose fixation and mental state,changes in posture and restraint,blockage of gastric tubes,and turning over and dressing.By taking corresponding nursing interventions,the incidence of unplanned extubation can be reduced,which plays an important role in improving the prognosis of patients.

关 键 词：老年痴呆 非计划性拔管 长期鼻饲 护理干预 

分 类 号：R473.74[医药卫生—护理学]