呼吸道强化管理在胸腔镜下体外循环先天性心脏病手术中的应用价值

The application value of respiratory tract intensive nursing in thoracoscopic CPB surgery

目的探究呼吸道强化护理在胸腔镜下体外循环先天性心脏病(先心病)手术中的应用价值。方法选取2018年1月至2019年6月心血管外科手术室行胸腔镜下体外循环先心病手术的80例先心病患儿作为研究对象,按照奇偶数法分为2组,每组40例。对照组采用常规手术室护理,观察组在常规手术室护理基础上,实施呼吸道强化护理,对比2组患儿的肺通气指标水平、住院时间、术后并发症发生率等指标,并评估患儿家属的护理满意度。结果术中及手术后8 h,观察组患儿动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、血氧饱和度(SpO_(2))等指标高于对照组患儿(P<0.05),与术前相比,观察组患儿术中及术后8 h肺通气指标差异无统计学意义(P>0.05),肺通气指标波动范围较小;观察组患儿住院时间短于对照组患儿(P<0.05);手术起始至出院期间,观察组患儿并发症发生率低于对照组患儿(P<0.05);观察组患儿家属护理满意度高于对照组患儿家属(P<0.05)。结论在胸腔镜下体外循环先心病手术中实施呼吸道强化护理,可维持患儿肺通气功能的稳定性,降低并发症发生率,缩短住院时间,提高患儿家属对护理的满意度。

Objective To investigate the application value of respiratory tract intensive nursing in thoracoscopic cardiopulmonary bypass surgery(CPB)in treatment of congenital heart disease.Methods Eighty children with congenital heart disease who were treated by CPB in our hospital from January 2018 to June 2019 were enrolled in the study,who were divided into two groups according to the even-odd method,with 40 cases in each group.The patients in control group were treated by routine operating room nursing during the operation,however,the patients in observation group,on the basis of control group,were treated by respiratory tract intensive nursing.The levels of pulmonary ventilation indexes,length of staying in hospital,the incidence rate of postoperative complications and nursing satisfaction degree of the patient’s family members were observed and compared between the two groups.Results The levels of intra-arterial blood oxygen pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),and blood oxygen saturation(SpO_(2))during operation and at 8h after surgery in observation group were significantly higher than those in control group(P<0.05).As compared with those before surgery,the lung ventilation indexes during operation and at 8h after operation were not changed significantly(P>0.05),and the hospital stay and the incidence rate of complications in observation group were significantly less than those in control group(P<0.05),however,the satisfaction degree of patient’s family members in observation group was significantly higher than that in control group(P<0.05).Conclusion The respiratory tract intensive nursing during thoracoscopic CPB in treatment of congenital heart disease can maintain the stability of pulmonary ventilation function,reduce the incidence of complications,shorten the length of staying in hospital,and improve the satisfaction degree of patient’s family members.