心脏直视手术后病人个体化液体入量指导方法的研究

Study on guiding methods on individualized fluids intake quantity for postoperative patients after cardiac operation under direct vision

[目的]研究心脏直视手术后病人个体化液体入量指导方法。[方法]选择风湿性心脏病体外循环直视手术后病人100例,随机分为常规对照组(50例)和个体化指导组(50例),常规对照组采用常规入量指导方法;个体化指导组采用护理程序的方法指导病人的液体入量。对病人实施两种液体入量指导方法前及指导后第2天、第4天、第6天均应用液体情况评估表评价病人体内的液体情况,根据得分情况分别统计出液体偏多、合适及不足的人数。采用视觉评分法(VAS)测评两组病人指导当日及第2天、第4天、第6天的舒适度。[结果]两组病人在指导后的第2天、第4天、第6天液体偏多、合适及不足的人数构成比以及舒适度得分比较,差异均有统计学意义(P<0.05)。[结论]以护理程序为指导思想的个体化液体入量指导方法有效地保证了心脏手术后病人体内适当的液体量,提高了病人的舒适度。

Objective：To study on instruction method for individualized fluids intake of patients after undergoing open heart surgery.Methods：A total 100 patients with rheumatic heart disease and accepted open heart surgery were randomly divided into control group （50 cases） and test group （50 cases）.Patients in control group received conventional instruction on fluid intake.Patients in test group were given individualized instruction on fluid intake by adopting nursing procedure.The internal fluids conditions of all cases were evaluated by using fluid evaluation scale before instruction and on the second day,the forth day and the sixth day after instruction respectively.The numbers of patients of fluids overloading,moderate and inadequate were calculated based on their scorings.And the degree of comfort of patients on the instruction day,the second day,the fourth day,and the sixth day after instruction were measured by visual analogue scale （VAS）.Results：There were statistical significant differences in terms of comfort degree scorings and constituent ratios of overloading,moderate and inadequate of fluids on the second day,the forth day,and the sixth day after instruction between the two group cases （P0.05）.Conclusion：The individualized fluid intake instruction guided by nursing procedure may ensure appropriate fluid intake of patients effectively and enhance the degree of comfort for patients.