心脏病开胸术后俯卧位通气清单式管理效果观察  

Effect of applying checklist for performing prone positioning during mechanical ventilation after thoracotomy for open-heart surgery

作　　者：陶建 宋亚敏[1] 万颖颖 李万玖 高树联 周萌 林丽霞[1] Tao Jian;Song Yamin;Wan Yingying;Li Wanjiu;Gao Shulian;Zhou Meng;Lin Lixia(Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital of Southern Medical University(Guangdong Academy of Medical Sciences),Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所南方医科大学附属广东省人民医院(广东省医学科学院),广东广州510080

出　　处：《护理学杂志》2023年第20期25-30,共6页Journal of Nursing Science

基　　金：广东省医学科学技术研究基金项目(A2022290)。

摘　　要：目的 提高心脏开胸术后患者低氧血症俯卧位护理效果与安全。方法 将110例患者按时间段分为对照组与观察组各55例;对照组采取“信封法”实施俯卧位操作和常规护理;观察组制定和实施俯卧位操作清单。结果 观察组俯卧位准备时长、俯卧位治疗结束后机械通气时长、面部水肿发生率显著少于对照组(均P<0.05),观察组俯卧位总时长显著长于对照组、转换仰卧位后氧合指数显著高于对照组(均P<0.05)。结论 清单式管理优化了心脏开胸术后患者俯卧位操作流程,有效提高护理效率,增加俯卧位通气效果,减少相关并发症,有利于保障患者安全和尽早脱离呼吸机。Objective To improve the effectiveness and safety of prone position care for hypoxaemia in patients after open-heart surgery.Methods A total of 110 patients were divided into a control group and an observation group chronologically,with 55 in each group.The control group used the"envelope method"to perform prone position,while the observation group developed a prone checklist for performing prone position.Results Compared with the control group,the observation group had significantly shorter time spent preparing prone position,shorter duration of mechanical ventilation after prone position treatment,lower incidence of facial edema,longer duration of prone position,and higher oxygenation index after turning in the supine position(all P<0.05).Conclusion Checklist-based management optimizes operative process of prone position in patients after open-heart surgery,effectively improves nursing efficiency,enhances the effect of prone ventilation,reduces related complications,and contributes to patient safety and early withdrawal from the ventilator.

关 键 词：心脏疾病 开胸手术 低氧血症 俯卧位通气 信封法管理 清单式管理 外科护理 

分 类 号：R473.6[医药卫生—护理学]