不同频次唤醒护理对全身麻醉胸科腔镜手术后患者苏醒效果的影响  

Effect of wake-up nursing with different frequencies on the recovery of patients undergoing endoscopic thoracic surgery under general anesthesia

作　　者：代恒茂 余遥[1] 刘尚昆 杨莹[1] 邱晓慧 Dai Hengmao;Yu Yao;Liu Shangkun;Yang Ying;Qiu Xiaohui(Department of Anesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,湖北武汉430030

出　　处：《护理学杂志》2024年第7期61-64,共4页Journal of Nursing Science

基　　金：华中科技大学同济医学院附属同济医院科研基金项目(2022D03)。

摘　　要：目的探讨不同频次的唤醒护理对全身麻醉胸科腔镜手术后带气管导管转入麻醉后监测治疗室(PACU)患者苏醒效果的影响。方法采用便利抽样法,选取全身麻醉胸科腔镜手术后带气管导管转入气管导管观察的116例患者为研究对象,探讨不同频次(试验组A每5分钟、试验组B每10分钟、对照组等待患者自然苏醒)的唤醒护理对气管导管拔管时间、拔管后苏醒时间、总苏醒时间、拔管时呛咳反应、苏醒期躁动、拔管成功率、拔管后低氧血症和平均动脉压波动发生率的影响。结果气管导管拔管时间三组比较差异有统计学意义,试验组A和试验组B显著短于对照组(均P<0.05);试验组A与试验组B差异无统计学意义(P>0.05)。拔管后苏醒时间三组比较差异有统计学意义,试验组A显著长于对照组(P<0.05)。总苏醒时间三组比较差异无统计学意义(P>0.05)。三组气管导管拔管成功率和拔管后低氧血症发生率比较,差异无统计学意义(均P>0.05)。与对照组相比,试验组A和试验组B拔管时呛咳反应、苏醒期躁动程度和拔管后平均动脉压波动发生率明显降低(均P<0.05)。结论5 min和10 min频次的唤醒护理均能有效减少全身麻醉胸科腔镜手术后患者在气管导管机械通气时间,降低拔管时呛咳反应和苏醒期躁动严重度,有利于维持拔管时血流动力学稳定,提高苏醒质量。Objective To explore the effect of wake-up nursing with different frequencies on the recovery of patients transferred to PACU with endotracheal tube after endoscopic thoracic surgery under general anesthesia.Methods A total of 116 patients transferred to PACU with endotracheal tube after endoscopic thoracic surgery under general anesthesia were selected by convenience sampling method.To explore the effects of different frequencies(experimental group A every 5 minutes,experimental group B every 10 minutes,control group waiting for natural recovery)wake-up nursing on extubation time of endotracheal tube,recovery time after extubation,total recovery time,the degree of cough and agitation during recovery,success rate of extubation,incidence of hypoxemia and mean arterial pressure fluctuation after extubation.Results The extubation time of endotracheal tube was significantly different among the three groups,with the duration significantly shorter in the experimental group A and B than that in the control group(both P<0.05),while there was no statistically significant difference between group A and group B(P>0.05).The recovery time after extubation was significantly different among the three groups,with the duration significantly longer in the group A than that in the control group(P<0.05).There weren′t statistically significant differences in the total recovery time,the success rate of extubation and the incidence of hypoxemia after extubation among the three groups(all P>0.05).When compared with the control group,the degree of cough and agitation during recovery and the incidence of mean arterial pressure fluctuation after extubation in group A and group B were significantly lower(all P<0.05).Conclusion Both 5 min and 10 min frequency of wake-up nursing can reduce the PACU mechanical ventilation time for patients after endoscopic thoracic surgery under general anesthesia,alleviate the severity of cough and agitation during recovery,maintain hemodynamic stability during extubation and improve the quality of recovery

关 键 词：胸科腔镜手术 全身麻醉 苏醒期 麻醉后监测治疗室 唤醒护理 护理频次 苏醒期躁动 麻醉护理 

分 类 号：R472.3[医药卫生—护理学]