围术期感染护理路径在预防胸部手术后肺部并发症中的应用

Application of perioperative infection nursing pathway in pulmonary complications prevention after thoracic surgery

目的：评价围术期感染护理路径效果，为胸部手术患者围术期临床护理提供指导。方法按住院号将106例胸部手术患者随机分为观察组（单号）与对照组（双号）各53例，比较两组患者的平均住院天数、住院费用、痰液及口咽细菌检出率、患者满意度。结果实施围术期感染护理标准化路径后，观察组平均住院天数、住院费用分别为（7．16±0．83） d，（1．09±0．54）万元，明显优于对照组的（10．45±1．51）d，（1．44±0．65）万元，差异有统计学意义（t值分别为－2．260，－7．958；P＜0．05），观察组患者的依从性评分为（2．58±0．62）分，明显高于对照组的（1．21±0．55）分，差异有统计学意义（t＝6．334，P＜0．05）；术后3 d，观察组痰液细菌阳性2例（3．77％）、口咽细菌阳性3例（5．66％），明显低于对照组阳性检出率18．87％，28．30％，差异有统计学意义（χ^2分别为4．357，6．150；P＜0．05）；观察组患者对手术室护理服务工作的满意度达100％，平均得分为（4．68±0．83）分，明显高于对照组的（3．01±1．02）分，差异有统计学意义（ t＝3．467，P＜0．05）。结论设立胸部手术患者围术期感染护理标准化路径，既可以使围术期护理内容更全面规范；而且可指导实施预见性护理措施，有效提升手术效果，最大限度提高患者意度。

Objective To evaluate the effect of perioperative nursing pathway on lung complications after thoracic surgery, so as to provide new evidence for the perioperative nursing pathway in the patients undergoing thoracotomy.Methods Totals of 106 patients who underwent thoracic surgery were randomly divided into observed group （n=53,double） and control group （n=53,odd）.Then, hospitalization days, costs, sputum and oropharyngeal bacteria, patients satisfaction of two groups were observed and compared.Results After perioperative nursing pathway application, in observation group, the average days of hospitalization was significantly shorten （7.16 ±0.83 vs 10.45 ±1.51;t=-2.260,P〈0.05）,the cost （1.09 ±0.54 vs 1.44 ±0.65;t=-7.958,P〈0.05） was significantly reduced, and compliance was greatly improved than that in control group （2.58 ±0.62 vs 1.21 ±0.55;t=6.334,P〈0.05）.Laboratory tests showed that two cases with sputum bacteria positive （3.77%vs 18.87%） and three cases with oropharyngeal bacteria positive （5.66% vs 28.30%） in observation group was significantly lower than that in control group（χ^2=4.357, 6.150,respectively,P〈0.05）.Patients satisfaction of observation group was higher than control group,and the difference was statistically significant （ 4.68 ±0.83 vs 3.01 ±1.02;t =3.467, P 〈0.05 ） . Conclusions Perioperative nursing pathway is positive and beneficial to prevent lung complications after thoracic surgery, which can improve the operation efficiency and patients satisfaction.