体外循环心脏术后患者口渴的发生现状及相关因素分析

Status quo and influencing factors of thirst in patients receiving cardiopulmonary bypass

目的调查体外循环心脏手术患者拔管后禁食禁饮期间口渴的发生情况,探讨其影响因素。方法采用前瞻性研究设计,选取2017年12月—2018年5月在南京市某三甲医院行心脏手术的患者120例。通过一般资料调查表收集相关资料,测量患者的口渴评分和静息唾液流率,采用SPSS 24.0软件分析患者术后口渴的影响因素。结果体外循环心脏术后患者在拔管后6 h内的口渴发生率为100%,口渴评分为(6.20±1.90)分,随着时间的延长患者的口渴程度逐渐增强。单因素分析显示,患者术后口渴评分与术后体温、呼吸频率、血钠浓度、尿量呈正相关(r值分别为0.172、0.105、0.209、0.258;P<0.05),与术后液体平衡量、静息唾液流率呈负相关(r值分别-0.222、-0.565;P<0.05)。多因素分析显示,静息唾液流率和液体平衡量是心脏术后患者发生口渴的主要影响因素(P<0.05)。结论体外循环心脏术后患者口渴的发生率较高,其发生与多种因素有关。护理中应关注心脏术后患者的口渴情况,有针对性地采取措施缓解患者的口渴症状,提高患者舒适度。

Objective To explore the status quo of thirst in patients receiving cardiopulmonary bypass (CPB) during fasting and water deprivation after extubation and to analyze its influencing factors. Methods Totally 120 patients undergoing CPB in a Class Ⅲ Grade A hospital in Nanjing from December 2017 to May 2018 were selected in this prospective study. The general information questionnaire was used to collect the data, and the patients' thirst score and unstimulated salivary flow rate (USF) were measured. SPSS 22.0 was used to analyze the factors affecting postoperative thirst in the patients. Results The incidence rate of thirst in the CPB patients 6 h post extubation was 100%, and their thirst score was (6.20±1.90);and the patients' thirst intensified over time. Univariate analysis showed that the patients' postoperative thirst was positively correlated with postoperative body temperature, respiratory rate, serum sodium concentration and urinary volume (r=0.172, 0.105, 0.209, 0.258;P<0.05), and negatively correlated with postoperative fluid balance volume and USF (r=-0.222,-0.565;P<0.05). Multivariate analysis showed that USF and fluid balance volume were the main influencing factors to thirst in the patients (P<0.05). Conclusions The incidence rate of thirst in CPB patients is relatively high and it is associated with multiple factors. Nurses should pay attention to the patients' thirst and take targeted measures to ameliorate their thirst to improve their comfort in nursing practice.