整体护理在合并心律失常的老年患者无痛胃镜检查中的应用

Application of holistic nursing in painless gastroscopy examination for elderly patients with arrhythmia

目的探讨整体护理在合并心律失常的老年患者无痛胃镜检查中的应用。方法总结2010年1月~2014年3月,门诊及住院行无痛胃镜检查的老年患者217例,年龄60~78岁,平均67.5岁。心律失常类型：窦性心动过速33例、窦性心动过缓16例、ST-T改变71例、室性早搏14例、室上性早搏29例、房性早搏23例、室性早搏合并ST-T改变19例、房性早搏合并ST-T改变12例。分别在无痛胃镜检查前、检查过程中及检查后对患者进行整体护理干预。结果全部患者均顺利完成无痛胃镜检查,术中出现一过性心率加快或减慢、血压下降24例,一过性SPO2下降45例,经报告麻醉医师予以及时处理后生命体征均恢复正常。全部患者术中均未出现严重心律失常、心肌缺血改变。电话或问卷调查显示患者的总体满意度为95.4%,80.6%的患者愿意再次接受同样检查。结论无痛胃镜检查是一种具有潜在风险的检查和治疗手段,整体护理干预可明显提高无痛胃镜检查的安全性和患者满意度。

Objective To study the holistic nursing in painless gastroscopy examination for elderly patients with arrhythmia.Methods From January 2010 to March 2014,217 elderly outpatients and inpatients received painless gastroscopy examination.The patients aged from 60~78 years,average 67.5 years old.Arrhythmia types： 33 cases with Sinus tachycardia,16 cases with sinus bradycardia,71 cases with ST-T changes,14 cases with premature ventricular contractions,29 cases with Supraventricular premature beats,23 cases with atrial premature beats,19 cases with premature ventricular contractions combined ST-T changes,12 cases with atrial premature beats combined ST-T changes.All patients have received holistic nursing respectively before painless gastroscopy inspection,the inspection process and after the inspection.Results All patients have been successfully in painless gastroscopy examination,24 cases with transient speed up or slow down the heart rate,blood pressure drop,45 cases with transient slow down the SpO_2.Vital signs back to normal after anesthesiologists processed promptly.There is no serious arrhythmias,myocardial ischemic changes in all patients,overall satisfaction of patients by telephone or survey was 95.4%,80.6% of patients were willing to accept the same examination again.Conclusion Painless gastroscopy examination has potential risks,holistic nursing intervention can significantly improve safety and patient satisfaction in painless gastroscopy examination.