图文式临床路径干预模式在糖尿病足患者椎管内麻醉恢复期护理中的应用价值  

Application Value of Graphic Clinical Pathway Intervention Model in the Anesthesia Convalescent Nursing of Patients with Diabetic Foot Undergoing Intraspinal Anesthesia

作　　者：王爱环 何军霞 杜彩凤 冯慧芳 WANG Aihuan;HE Junxia;DU Caifeng;FENG Huifang(Department of Burn Plastic Surgery and Wound Repair,Kaifeng Central Hospital,Kaifeng 475200,China)

机构地区：[1]开封市中心医院烧伤整形与创面修复外科,河南开封475200

出　　处：《河南医学研究》2024年第23期4406-4409,共4页Henan Medical Research

摘　　要：目的观察图文式临床路径干预模式在椎管内麻醉糖尿病足患者麻醉恢复期护理中的应用价值。方法招募2021年1月至2023年6月拟在开封市中心医院行椎管内麻醉的80例糖尿病足患者为研究对象,根据手术顺序,使用随机数表法分为观察组和对照组,各40例。对照组接受常规麻醉恢复期护理,观察组接受图文式临床路径干预模式护理。比较两组监护指标[心率、呼吸频率、血氧饱和度、平均动脉压、体温、修订版Wong-Baker面部表情疼痛评估法(FPS-R)]、认知功能[术前、术后6 h的蒙特利尔认知评估量表(MoCA)得分、术后3 d内谵妄发生率]、苏醒期并发症、恢复时间(首次下地时间、排气时间、住院时间)。结果两组体温、血氧饱和度、平均动脉压比较差异无统计学意义(P>0.05),观察组心率、呼吸频率、FPS-R得分低于对照组,差异有统计学意义(P<0.05);两组术后3 d内谵妄发生率比较差异无统计学意义(P>0.05),术后6 h观察组MoCA得分高于对照组,差异有统计学意义(P<0.05);观察组苏醒期并发症总发生率低于对照组,差异有统计学意义(P<0.05);观察组首次下地时间、排气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论图文式临床路径干预模式用于椎管内麻醉糖尿病足患者麻醉恢复期护理中可减少认知功能影响及苏醒期并发症发生,对促进术后恢复有利。Objective To observe the application value of graphic clinical pathway intervention model in the anesthesia convalescent nursing of patients with diabetic foot undergoing intraspinal anesthesia.Methods A total of 80 patients with diabetic foot who were to receive intraspinal anesthesia in Kaifeng Central Hospital from January 2021 to June 2023 were recruited as the research subjects.According to the surgical sequence,the patients were divided into observation group and control group by using random number table method,with 40 cases in each group.The control group received routine anesthesia convalescent nursing,and the observation group was given graphic clinical pathway intervention model nursing.Monitoring measures[heart rate,respiratory rate,oxygen saturation,mean arterial pressure,body temperature,revised Wong-Baker facial expression pain assessment(FPS-R)],cognitive function[Montreal cognitive assessment(MoCA)score before surgery and at 6 hours after surgery,incidence rate of delirium within 3 days after surgery],complications during recovery and recovery time(first ambulation time,exhaust time,hospital stay)were compared between the two group.Results There were no statistically significant differences in body temperature,blood oxygen saturation and mean arterial pressure between the two groups(P>0.05).The heart rate,respiratory rate and FPS-R score in observation group were lower than those in control group(P<0.05).There was no statistical difference in the incidence rate of delirium within 3 days after surgery between the two groups(P>0.05),and the MoCA score in observation group at 6 hours after surgery was higher than that in control group(P<0.05).The total incidence rate of complications during recovery in observation group was lower than that in control group(P<0.05).The first ambulation time,exhaust time and hospital stay in observation group were shorter compared with those in control group(P<0.05).Conclusion Graphic clinical pathway intervention model can reduce the influence of cognitive function a

关 键 词：糖尿病足 图文式临床路径干预模式 椎管内麻醉 麻醉恢复期护理 认知功能 

分 类 号：R587.1[医药卫生—内分泌]