留置鼻胆管对患者生理舒适度的影响和相关因素分析

The discomfort and influencing factors in patients undergoing indwelling nasal biliary drainage

目的探讨留置鼻胆管对患者生理舒适度的影响和相关因素。方法采用描述性研究设计,对消化胆胰内科60例留置鼻胆管的住院患者进行调查。内容包括一般资料、留置鼻胆管期间的不适反应及程度。结果留置鼻胆管期间的不适反应包括:鼻腔刺激,恶心呕吐,咽喉部不适,口干舌燥,腹部不适,颈部活动受限,睡眠障碍。禁食期间轻度不适51.7%,中度不适26.7%,重度不适10.0%;进食期间轻度不适40.0%,中度不适18.3%,重度不适3.3%,进食前后患者舒适度比较,差异有统计学意义(P<0.01)。恶心呕吐和口干舌燥两项舒适度在禁食和进食期间的差异有统计学意义(P<0.05);麻醉方式和引流效果是引起恶心呕吐的主要影响因素。结论留置鼻胆管期间存在不同部位、不同程度及不同时间的不适反应,护理人员应给予有针对性的护理措施,从而提高患者对鼻胆管的耐受性,减轻不愉快感受,有利于改善留置鼻胆管患者的生活质量和减少自行拔管率。

Objective To investigate the level and influencing factors of discomfort in patients undergoing indwelling nasal biliary drainage. Method Sixty patients undergoing indwelling nasal biliary drainage were investigated with a self-questionnaire about the level of discomfort responses. Results The discomfort responses caused by indwelling nasal biliary drainage included nasal irritation, nausea and vomiting, sore throat, thirsty, abdominal discomfort, restriction of neck activity and sleep disorders. During the period of fasting,51.7%,26.7% and 10% of the patients suffered from mild,moderate and severe level of discomfort, respectively;during the non-fasting time,40%,18.3% and 3.3% of the patients suffered from mild,moderate and severe level of discomfort,respectively. There were significant differences in the general level of discomfort response（P〈0.01）,as well as the degree of nausea,vomiting and thirsty between the two periods（P〈0.05）. The anesthesia method and ineffective drainage were the main factors caused nausea and vomiting. Conclusion The patients undergoing indwelling nasal biliary drainage suffer from different degrees of discomfort responses in different body parts during different periods. Nurses shuold take targeted measures to improve the tolerance of patients with indwelling nasal biliary drainage and reduce their discomfort responses,which is ben- efit for improving the quality of life and decreasing the incidence of self-extubation.