胃癌根治术后收缩压的影响因素及护理对策

The influencing factors and nursing countermeasures of systolic pressure in patients after radical resection of gastric cancer

目的：了解胃癌根治术后第一天收缩压升高的患病率及影响因素，为护理提供依据。方法采用整群随机抽样方法，选择2012年12月∽2013年6月我科行胃癌根治术的患者95例，记录临床资料、问卷调查，主观因素进行视觉模拟评分方法，及其影响因素。结果术后第一天收缩压（mmHg）101∽222，极差 R＝121，≥140mmHg 的患病率48．42％。术后第一天收缩压与性别、咳嗽咳痰、导尿不适感、切口减张缝合、辅助化痰治疗、咳嗽时捂切口的方法是否正确、腹带松紧适度有关，咳嗽咳痰是术后第一天收缩压升高的危险因素，OR＝22．67（95％ CI：4．6∽111．3，P＜0．01），咳嗽时正确捂住切口是保护因素，OR＝0．022（95％ CI：0．004∽0．108，P＜0．01）。结论胃癌根治术后第一天收缩压变异大，应针对危险因素强化气道、疼痛、心理护理等相关措施。

Objective To investigate the prevalence and influencing factors of high systolic pressure in the first day after operation（SPFDAO） in patients experienced radical resection of gastric cancer ,to facilitate nursing .Methods 95 cases in the First Affiliated Hospital of Anhui Medical University from December 2012 to June 2013 were selected with cluster ran‐dom sampling ,clinical data were recorded and questionnaire survey was conducted ,subjective factors were measured using visual analogue scale ,the distribution and influencing factors of SPFDAO were analyzed using SPSS 17 .0 .Results SPFD‐AO was （101∽222） mmHg and range was 121mmHg ,prevalence of ≥140mmHg SPFDAO was 48 .42% ;Crosstabχ2 test showed that factors including sex ,cough and phlegm ,urethral discomfort ,incision relaxation suture ,auxiliary treatment of phlegm ,incision protective methods ,tightness degree of bellyband were related to SPFDAO ;Logistic model analysis showed that cough and phlegm were risk factors for high SPFDAO ,OR=22 .67（95% CI：4 .6∽111 .3 ,P〈0 .01） ,however ,incision protective methods were protective factors for normal SPFDAO ,OR=0 .022（95% CI：0 .004∽0 .108 ,P〈0 .01） .Conclusion the variation of SPFDAO in patients experienced radical resection of gastric cancer is big ,measures such as airway nursing , pain nursing ,psychological nursing and so on should be strengthened according to related influencing factors .