妇产科急症术中出血的急救护理体会

ACUTE BLOOD LOSS IN OBSTETRICS AND GYNECOLOGY NURSING AID

目的探讨妇科急腹症患者的术中急救护理措施。方法对1 364例妇科急腹症患者术前进行风险评估,术中加强手术配合以及出血量的观察与急救护理。结果 1 364例手术均顺利完成,无严重手术及麻醉并发症;手术时间20～150 m in;术中出血量500～3 000 mL,平均1 500 mL;术中平均输液量2 000 mL;手术时间>100 m in者986例,平均输液量2 400 mL。输液量与手术时间呈正相关(r=0.524,P<0.01);16例估计失血量大于800 mL的患者及时进行输血治疗,平均输血量400 mL。入院后直接进入手术室,术后8～9 d痊愈出院。结论妇科急腹症患者术前进行风险评估,术中加强手术配合以及出血量的观察与急救护理,是提高抢救成功率的重要保证。

Objective To study the intraoperative first-aid nursing measures for patients with gynecologic acute abdomen.Methods 1364 cases of gynecologic acute abdomen received risk assessment before surgery.The operative cooperation was strengthened,the observation of intraoperative blood loss was conducted and the first-aid nursing measures were taken.Results The operations of 1364 cases were successfully completed without any serious operative or anesthetic complications.The operative time was between 20 minutes and 150 minutes,the average amount of blood loss was between 500 ml to 3000,an average of 1500 ml and the mean infusion volume was 2 000 ml.986 cases had their operation time of more than 100 minutes and the average transfusion amount of 2 400 ml.The transfusion amount volume was positively correlated with the operative time（r=0.524,P0.01）.16 cases had the estimated blood loss of more than 800 ml of blood and received the average amount of blood transfusion 400 ml.The patients got admission directly into the operating-room and were discharged 8 to 9 days after surgery.Conclusion Preoperative risk assessment,intraoperative cooperation,the observation of blood loss and first-aid nursing measures are the key to successful operation.