不同时段颈内深静脉置管术对妇科手术患者的影响

The effect evaluation of internal jugular deep vein puncture technique in the different periods of patients with gynecological surgery

目的:在分析颈内静脉置管技术与操作规范的基础上,探讨不同时段置管对手术患者的影响以及有效的护理干预措施,以确保治疗质量,减少并发症的发生,为临床妇科手术患者护理提供依据。方法:选取60例腹腔镜手术患者,采用随机数表法将其分为观察组与对照组,每组30例。对照组患者给予手术前1 d进行颈内深静脉置管术,置管后距离手术时间>12 h,采用常规护理;观察组患者给予手术当日进行颈内深静脉置管术,置管后距离手术时间<2 h,并进行针对性的个性化护理措施。通过自制的调查问卷和疼痛强度评估对患者进行调查,了解患者并发症的发生及不同的心理感受,并采取进行有针对性的护理措施。结果:观察组置管后患者恐惧心理、疼痛和舒适度均优于对照组,差异有统计学意义(x^2=11.279,x^2=27.778,x^2=24.310;P<0.05),两组穿刺点渗血、渗液和穿刺失败的比较,其差异无统计学意义(x^2=1.964,x^2=1.071;P>0.05),但均有明显改善。结论:观察组行颈内深静脉置管距离手术时间短,患者主诉少,可预防和减少置管期间并发症的发生,保证治疗质量,促进患者及早康复。

Objective：To explore the experience and effective nursing measures for patients with internal jugular vein catheter in the treatment of the patients in different periods and provide the basis for clinical nursing.Methods： Randomly 60 cases of laparoscopic surgery in patients were selected and divided into the observation group and control group, 30 cases in each group. The patients in the control group received deep internal jugular vein catheterization 1 day before surgery and the routine nursing care. The distance from operation time was more than 12 hours after catheter. The observation group was treated with deep internal jugular vein catheterization surgery the same day and personalized nursing measures. The distance from operation time was less than 2 hours after catheter. Through the self-made questionnaire and pain intensity assessment of patients to investigate, we understand the occurrence of patients with complications and different psychological feelings, and give targeted nursing.Results： The aspects of fears, pains and comforts from patients in the observation group after the catheter were superior to the control group, and the difference is statistically significant （x2=11.279,x2=27.778,x2=24.310, P〈0.05）. In the point of puncture oozing of blood and exudate and failing to puncture, the difference was not statistically significant （x2=1.964,x2=1.071,P〉0.05）, but there are obviously improved.Conclusion： The operation time is shorter in the observation group. It can make the patients complain less, prevent and reduce catheter complications during the occurrence, ensure the quality of treatment and promote the patient’s rehabilitation.