集束化护理在全麻患者苏醒期意外拔管防范中的应用

Application of clustering nursing in the prevention of accidental extubation among patients with general anesthesia

目的探讨集束化护理在全麻患者苏醒期意外拔管防范中的应用效果,为提升全麻苏醒期患者安全提供参考。方法选择2017年5—11月在我院全麻下行手术治疗的患者128例作为对照组,采用常规护理路径进行全麻围麻醉期护理;选择2017年12月至2018年6月在我院全麻下行手术治疗的患者128例作为观察组,采用集束化护理进行围麻醉期护理。比较两组患者苏醒期呼吸恢复时间、苏醒时疼痛评分(VAS)、镇静评分(Ramsay)、躁动评分、Steward苏醒评分、BCS舒适度评分及约束带脱落率、躁动坠床率、误吸率、引流不畅率、意外拔管率。结果两组患者呼吸恢复时间、苏醒评分比较差异无统计学意义(P> 0. 05)。观察组患者苏醒时VAS评分、躁动评分明显低于对照组(P <0. 05),舒适度评分、镇静评分高于对照组(P <0. 05)。观察组患者约束带脱落率、躁动坠床率、误吸率、引流不畅率、意外拔管率低于对照组(P<0. 05)。结论集束化护理可有效改善全麻患者苏醒期不适感受、提升患者苏醒质量,降低苏醒期意外拔管率,提高全麻患者苏醒期安全性,具有较高的临床价值。

Objective To explore the application effect of clustering nursing in the prevention of accidental extubation among patients with general anesthesia,and to provide reference for improving the safety of patients during general anesthesia recovery.Methods A total of 128 patients who underwent surgery under general anesthesia in our hospital from May 2017 to November 2017 were selected as the control group,and they were treated with routine nursing pathway for perianesthesia of general anesthesia.A total of 128 patients who underwent surgery under general anesthesia in our hospital from December 2017 to June 2018 were selected as the observation group,and they were treated with clustering nursing for perianesthesia.The respiratory recovery time at recovery period,recovery visual analogue scale(VAS)score,sedation score(Ramsay),agitation score,Steward recovery score,BCS comfort score and constraint band shedding rate,drop rate of bed due to agitation,aspiration rate,rate of poor drainage and accidental extubation rate of the patients in the two groups were compared.Results There was no significant statistical difference between the respiratory recovery time and recovery score between the two groups(P >0.05).The VAS score and agitation score of the observation group were significantly lower than that of the control group when the patients awaken(P<0.05).The comfort score and sedation score were higher than that of the control group(P<0.05).The constraint band shedding rate,drop rate of bed due to agitation,aspiration rate,rate of poor drainage and accidental extubation rate of the patients in the observation group were lower than that of the control group(P<0.05).Conclusion Clustering nursing can improve the uncomfortable feelings of patients with general anesthesia and the quality of recovery effectively.Moreover,it can reduce the accidental extubation rate during the recovery period,and improve the safety of patients with general anesthesia during the recovery period,and has higher clinical value.