流程化干预方式对神经外科侧卧位手术患者压力性损伤发生率及肩颈功能的影响  

Effect of streamlined intervention on the incidence of stress injury and shoulder and neck function in patients undergoing lateral decubitus neurosurgery

作　　者：谢美英[1] XIE Meiying(Operating Room,Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]江西省赣州市人民医院手术室,江西赣州341000

出　　处：《中国当代医药》2023年第30期177-180,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212443)。

摘　　要：目的探讨流程化干预方式在神经外科侧卧位手术患者中的应用效果及对压力性损伤、肩颈功能的影响。方法选取2021年1月至2022年9月于赣州市人民医院就诊并接受侧卧位手术的139例患者为研究对象,其中2021年1月至12月入院的患者采用常规护理方法为常规干预组(n=65),2022年1月至9月入院的患者采用流程化干预方式为流程化干预组(n=74)。比较两组患者的压力性损伤发生情况、术后不同时间神经功能缺损量表(NIHSS)评分、术后舒适度及护理满意度;比较两组患者的压力损伤面积、压力性损伤持续时间及护理相关费用。结果流程化干预组术后即刻、术后1 h、术后3 d的压力性损伤发生率低于常规干预组,差异有统计学意义(P<0.05)。流程化干预组干预后7、30d的NIHSS评分低于常规干预组,差异有统计学意义(P<0.05)。流程化干预组术后1d的上肢麻木、下肢麻木、紧张情绪、肩颈疼痛发生率低于常规干预组,差异有统计学意义(P<0.05)。流程化干预组的压力损伤面积小于常规干预组,压力性损伤持续时间短于常规干预组,护理相关费用低于常规干预组,差异有统计学意义(P<0.05)。流程化干预组的护理总满意度高于常规干预组,差异有统计学意义(P<0.05)。结论流程化干预方式应用于神经外科侧卧位手术患者可降低其压力性损伤发生率,改善患者肩颈功能,提高舒适度和护理满意度,值得临床推广应用。Objective To explore the application effect of streamlined intervention in neurosurgical patients with lateral de-cubing and its influence on stress injury and shoulder and neck function.Methods A total of 139 patients who received lat-eral decubitus surgery in Ganzhou People's Hospital from January 2021 to September 2022 were selected as the study ob-jects.Among them,patients admitted from January to December 2021 with routine nursing methods were classified as the routine intervention group(n=65).Patients admitted from January to September 2022 adopted the streamlined intervention mode as the process intervention group(n=74).The occurrence of stress injury,National Institute of Health stroke scale(NIHSS)score at different time after surgery,postoperative comfort and nursing satisfaction were compared between the two groups.The area of stress injury,duration of stress injury and nursing related costs were compared between the two groups.Results The incidence of stress injury immediately after surgery,1 h after surgery and 3 d after surgery in the process inter-vention group was lower than that in the conventional intervention group,and the differences were statistically significant(P<0.05).The NIHSS score of the process intervention group was lower than that of the conventional intervention group 7 and 30 days after intervention,and the differences were statistically significant(P<0.05).The incidence of upper limb numbness,lower limb numbness,tension and shoulder and neck pain 1 day after operation in the streamlined intervention group was lower than that in the conventional intervention group,and the differences were statistically significant(P<0.05).The area of pressure injury in the process intervention group was smaller than that in the conventional intervention group,the duration of pressure injury was shorter than that in the conventional intervention group,and the nursing related cost was lower than that in the conventional intervention group,the differences were statistically significant(P<0.05).The tota

关 键 词：流程化干预方式 神经外科 侧卧位手术 压力性损伤 神经功能 护理满意度 

分 类 号：R741[医药卫生—神经病学与精神病学]