全身麻醉后留置尿管患者护理干预对复苏期躁动的影响

Influence of nursing intervention on patients with retained ureter under general anesthesia on recovery agitation

目的分析全身麻醉后留置尿管患者护理干预对复苏期躁动的影响。方法资料选自2013年3月~2014年3月在浙江省肿瘤医院行择期全麻开胸手术男性患者126例,按照完全随机法1∶1分成两组,对照组63例患者予常规护理措施,研究组63例患者予护理干预,比较两组患者的疗效性、安全性与生命体征指标情况。结果研究组患者的躁动、尿道刺激与生命体征异常率均低于对照组,差异有统计学意义（6.35%比33.33%、11.11%比68.25%、4.76%比23.81%,P〈0.05）;研究组护理后的视觉模拟评分（VAS）、Ramsay评分及躁动评分均比对照组低,差异有统计学意义[（3.94±1.06）分比（6.53±4.27）分、（1.15±0.43）分比（2.14±0.54）分、（2.07±0.36）分比（3.75±0.53）分,P〈0.05）]。两组患者插管后5 min与拔管时的心率（HR）与收缩压（SBP）水平均有上升,插管后5 min的血氧饱和度（SPO2）均有上升,拔管时的SPO2显著下降。拔管后5 min的3项指标组间比较,差异有统计学意义（P〈0.05）。结论护理干预能够降低全身麻醉后留置导尿管患者复苏期的躁动发生率。

Objective To analyze the effect of nursing intervention on patients with retained ureter under general anesthesia on recovery agitation. Methods Data of 126 cases were randomly selected from the men patients who received electively open thoracic surgery under general anesthesia in Zhejiang Tumor Hospital from March 2013 to March 2014.According to 1∶1 proportion, patients were divided into two groups. 63 cases as the control group, were given the conventional nursing; 63 cases as the research group, were given the nursing intervention. And then the safety effect, therapeutic effect and vital signs index of the two groups were compared. Results The abnormal rates of agitation, urethral stimulation and vital signs indexin research group were all lower than those in control group, with statistical significances（6.35% vs 33.33%, 11.11% vs 68.25%, 4.76% vs 23.81%, P〈0.05）. VAS, Ramsay and agitation scores after nursing in research group were as well as lower than those in control group, with statistical significance [（3.94±1.06）scores vs（6.53±4.27） scores,（1.15±0.43） scores vs（2.14±0.54） scores,（2.07±0.36） scores vs（3.75±0.53） scores, P〈0.05]. 5 min after intubation, the level of HR and SBP on extubation and SPO2 of 5 min after intubation all ascended;while SPO2 on extubation descended obviously. There existed significant difference among the three indexes in 5 min after extubation, with statistical significances（P 0.05）. Conclusion Nursing intervention can reduce the incidence of recovery agitation of patients with retained ureter under general anesthesia and is worth applying in the clinical field.