神经外科手术患者术中获得性压力性损伤动态管理策略的制订及应用  

Development and application of dynamic management strategies for intraoperative acquired stress injuries in neurosurgery patients

作　　者：蒋维连 韦群梅 文宏英 王秀梅 魏虹 Jiang Weilian;Wei Qunmei;Wen Hongying;Wang Xiumei;Wei Hong(Operation Room,the Second Affiliated Hospital of Guilin Medical College,Guilin 541199,China;Operating Room,Guangxi International Zhuang Medical Hospital,Nanning 530000,China;Operating Room,Shanxi Bethune Hospital(Tongji Shanxi Hospital,Shanxi Academy of Medical Sciences),Taiyuan 030032,China;Department of Nursing,the Second Affiliated Hospital of Guilin Medical College,Guilin 541199,China)

机构地区：[1]桂林医学院第二附属医院手术室,桂林541199 [2]广西国际壮医医院手术室,南宁530000 [3]山西白求恩医院(山西医学科学院同济山西医院)手术室,太原030032 [4]桂林医学院第二附属医院护理部,桂林541199

出　　处：《中国实用护理杂志》2023年第31期2413-2419,共7页Chinese Journal of Practical Nursing

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2021014);广西卫健委科研课题(Z-C20220967、Z20211056);桂林医学院第二附属医院临床基础能力提升项目(2023gyefylc020);山西省卫生健康委科研课题(2022114)。

摘　　要：目的制订神经外科手术患者术中获得性压力性损伤(IAPI)动态管理策略并评价其实施效果,为IAPI管理提供建设性意见。方法采用非同期前后对照研究方法。2021年1月至2022年12月,采用便利抽样法选取桂林医学院第二附属医院神经外科手术患者220例为研究对象,按手术时间先后分为对照组和观察组各110例。对照组给予常规压力性损伤干预,观察组在常规压力性损伤干预基础上实施基于时机理论的IAPI动态管理方案。比较2组患者术前压力性损伤评分、IAPI发生率以及手术室护士压力性损伤管理自我效能。结果对照组、观察组患者术前压力性损伤评分分别为(14.69±2.93)、(14.78±2.89)分,差异无统计学意义(t=-0.23,P>0.05);对照组患者IAPI发生率为3.64%(4/110),观察组患者为0,差异有统计学意义(χ^(2)=4.07,P<0.05)。干预前后手术室护士压力性损伤管理自我效能评分分别为(29.13±4.87)、(36.41±5.83)分,干预前后比较差异有统计学意义(t=-6.21,P<0.05)。结论实施IAPI动态管理策略,能有效降低神经外科手术患者IAPI发生率,提升手术室护士压力性损伤管理自我效能。Objective To develop dynamic management strategies for intraoperative acquired pressure injuries(IAPI)in neurosurgery patients and evaluate their implementation effects,so as to provide constructive suggestions for the management of IAPI.Methods This study was conducted by a non-synchronous before and after control study.From January 2021 to December 2022,220 patients undergoing neurosurgery in the Second Affiliated Hospital of Guilin Medical College were conveniently selected as the study objects,and divided into the control group and the observation group with 110 patients in each group according to the time of operation.The control group was given routine nursing measures to prevent IAPI,and the observation group was given dynamic management program based on timing theory on bisis of routine nursing.The score of preoperative stress injury,incidence of IAPI and the self-efficacy scores of nurses in the management of stress injury in operating room were compared between the two groups.Results Before intervention,the scores of preoperative stress injury in control group and observation group were(14.69±2.93)points and(14.78±2.89)points,respectively,with no statistical significance(t=-0.23,P>0.05).After the intervention,the incidence of IAPI was 3.64%(4/110)in the control group and 0 in the observation group,and the difference was statistically significant(χ^(2)=4.07,P<0.05).The self-efficacy scores of nurses in the management of stress injury before and after intervention were(29.13±4.87)and(36.41±5.83),respectively,and the difference was statistically significant(t=-6.21,P<0.05).Conclusions The implementation of dynamic management strategy of IAPI can effectively reduce the incidence of IAPI in neurosurgery patients and improve the self-efficacy of nurses in operating room.

关 键 词：神经外科 手术中护理 时机理论 手术患者 压力性损伤 

分 类 号：R473.6[医药卫生—护理学]