程序化护理在心肺转流心脏外科手术中的应用

Application of programmed nursing in cardiopulmonary bypass cardiac surgery

目的探究程序化护理在心肺转流心脏手术中的应用及配合情况。方法选择2018年1—12月在大连市中心医院收治的111例择期行体外循环心脏手术患者为研究对象。按随机数字表法分为对照组54例,研究组57例。对照组采用常规术中护理,研究组应用程序化心肺转流下心脏外科手术护理。比较2组患者围手术期机械通气时间、手术时间、住院时间、术中护理不良事件发生率、并发症发生情况。结果研究组手术时间、机械通气时间、住院时间分别为(152.89±18.10)min、(8.30±2.27)h、(11.75±2.54)d,少于对照组的(182.04±18.39)min、(11.72±2.93)h、(14.26±2.97)d,差异有统计学意义(t=8.41、6.91、4.78,均P<0.01)。对照组中有8例术中护理不良事件发生,研究组未见术中不良事件发生,差异有统计学意义(χ^(2)=9.03,P<0.01)。所有患者无同时出现2种及以上并发症。研究组有3例(5.26%)患者出现术后并发症,低于对照组的14例(25.92%),差异有统计学意义(χ^(2)=9.03,P<0.05)。结论程序化护理在心肺转流心脏手术中,可有效减少手术时间和住院时间,降低术中不良事件以及术后并发症的发生,提高手术效率。

Objective Study the application of programmed nursing in the cooperation of cardiopulmonary bypass surgery.Methods From January 2018 to December 2018,111 consecutive patients undergoing elective cardiopulmonary bypass cardiac surgery in Dalian Municipal Central Hospital were selected as the research objects.According to the random number table method,they were divided into two groups.54 cases in the control group and 57 cases in the study group.The control group adopted the routine intraoperative care model,and the observation group was adopted the nursing of cardiac surgery under programmed cardiopulmonary bypass.The mechanical ventilation time,operation time,hospitalization time,incidence of adverse events of intraoperative nursing and complications were compared between the two groups.Results The operation time,mechanical ventilation time and hospitalization time in the study group were(152.89±18.10)min,(8.30±2.27)h and(11.75±2.54)d respectively,which were less than those in the control group(182.04±18.39)min,(11.72±2.93)h and(14.26±2.97)d,and the difference was statistically significant(t=8.41,6.91,4.78,all P<0.05).There were 8 cases of intraoperative nursing adverse events in the control group and no intraoperative adverse events in the study group,the difference was statistically significant(χ^(2)=9.03,P<0.01).All patients had no two or more complications at the same time.There were 3 cases(5.26%)of postoperative complications in the study group,lower than 14 cases(25.92%)in the control group,the difference was statistically significant(χ2=9.03,P<0.05).Conclusions In cardiopulmonary bypass surgery,programmed nursing can effectively reduce the operation time and hospitalization time,reduce the incidence of adverse events and postoperative complications,improve the efficiency of the operation.