麻醉前集中护理管理模式对择期手术患者应激的影响

Effect of anesthesia before mode on emergency response for the patients undergoing time selective operation

目的探讨择期手术患者入手术室后实施麻醉前集中护理管理模式对其应激的影响。方法选取择期手术患者236例，随机分为干预组和对照组各118例。干预组患者术日入手术室后在麻醉复苏间实施麻醉前集中护理管理，并进行相应的人文关怀等护理干预措施；麻醉前5—10min由巡回护士接入手术间，在巡回护士的人文关怀下进行麻醉手术。对照组以传统护理管理模式，入手术室后接入安排的相应手术间等待麻醉手术。评估比较两组患者心率、血压、血糖和心理状态的差异。结果干预组患者术后3d焦虑自评量表（SAS）评分结果为（42．3±3．8）分，对照组为（50．6±3．4）分，组间比较差异具有统计学意义（t=8．63，P〈0．01）。干预组患者麻醉前血糖为（4．7±0．3）mmol／L，心率为（78．3±7．4）次／min，收缩压为（16．9±0．3）kPa，对照组分别为（5．3±0．4）mmol／L、（95．3±7．6）次／min、（18．3±0．6）kPa，组间比较差异具有统计学意义（t值分别为14．10，7．82，8．12；P〈0．01）。结论术前集中护理管理并实施相关的护理干预，可降低患者的情绪反应，提高其后续的手术、治疗依从性，提高患者的术前安全性。

Objective To investigate the selective operation patients in operation room in anesthesia before nursing management model on the stress influence research. Methods 236 patients undergoing elective operation were randomly divided into intervention group and control group with 118 cases in each group. Intervention group patients, preoperative in anesthesia recovery in anesthesia before nursing management, and corresponding humanistic care nursing interventions, in 5 - 10 minutes before anesthesia by nurse access implementation of the operation, in the humane care of itinerate nurse performed under anesthesia operation. The control group with traditional nursing management in operation room, after access arrangement corresponding operation for waiting operation anesthesia. Heart rate, blood pressure, blood glucose and psychological condition were compared and analyzed between the two groups. Results In the preoperative 3d SAS of the intervention group and the control group were （ 42.3 ± 3.8 ） score and （ 50.6 ± 3.4 ） score, and they had significant difference （t = 8.63, P 〈 0.01 ） ; blood glucose, heart rate, systolic blood pressure of the intervention group before anesthesia were （4.7 ± 0.3 ） mmol/L, （78.3 ± 7.4）, times/min, （ 16.9 ± 0.3 ） kPa; in the control group they were （5.3 ±0.4） mmoL/L, （95.3 ±7.6） times/min, （18.3 ±0.6） kPa, and the differences were statistically significant （ t = 14.10, 7.82, 8,12, respectively,P 〈 0.01 ）. Conclusions Preoperative intensive care management and related nursing intervention pattern for patients with operation can reduce the patient＇ s emotional response; improve the follow-up operation and treatment compliance. Besides, it also enable patients to maintain good physical and mental condition and improve the patient＇ s preoperative safety, prevent nursing adverse events.