基于根因分析法的针对性干预在复杂胸主动脉夹层腔内隔绝术患者中的应用

Application of root cause analysis-based targeted intervention in patients underwent endovascular isolation surgery for complex thoracic aortic dissection

目的 探讨基于根因分析法的针对性干预在复杂胸主动脉夹层腔内隔绝术围手术期患者护理中的应用效果。方法选取2020年6月—2022年6月在郑州大学第一附属医院行腔内隔绝术治疗的84例复杂胸主动脉夹层患者,采用随机数字表法分为对照组与观察组,每组42例。对照组患者围手术期采用常规护理干预,观察组患者在对照组基础上采用基于根因分析法的针对性干预。比较2组患者的护理满意度,干预前后的心理状态及术后并发症发生情况。结果 观察组患者干预后健康教育、护理态度、护理环境及工作效率评分均高于对照组,差异均有统计学意义(P<0.05)。2组患者干预前焦虑自评量表(SAS)及抑郁自评量表(SDS)评分比较,差异均无统计学意义(P>0.05);2组患者干预后SAS及SDS评分均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率为7.14%,低于对照组的23.81%,差异有统计学意义(χ^(2)=4.459,P=0.035)。结论 对复杂胸主动脉夹层腔内隔绝术围手术期患者进行基于根因分析法的针对性干预效果显著,能有效改善患者心理状态,降低术后并发症发生风险,且患者护理满意度高,值得推广。

Objective This paper aims to explore the application of targeted intervention based on root cause analysis in perioperative care for patients underwent endovascular isolation surgery for complex thoracic aortic dissection.Methods The study enrolled 84 patients with complex thoracic aortic dissection who underwent endovascular isolation surgery at the First Affiliated Hospital of Zhengzhou University from June 2020 to June 2022.They were allocated to a control group and an observation group using a random number table,with 42 patients in each group.The control group received routine nursing intervention during the perioperative period,while the observation group received targeted interventions based on root cause analysis in addition to the routine intervention.Comparison was made between the two groups in terms of nursing satisfaction,psychological status before and after intervention,and postoperative complications.Results After intervention,the scores for health education,nursing attitude,nursing environment,and efficiency in the observation group were significantly higher than those in the control group(P<0.05).No statistically significant difference was observed in the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores between the two groups before intervention(P>0.05).However,after intervention,the SAS and SDS scores in both groups were lower than before intervention,and the scores in the observation group were lower than those in the control group,with statistical significance(P<0.05).The incidence of postoperative complications in the observation group was 7.14%,which was significantly lower than that in the control group(23.81%;χ2=4.459,P=0.035).Conclusion The targeted intervention based on root cause analysis during the perioperative period for patients with complex thoracic aortic dissection who underwent endovascular isolation surgery is effective in improving patients'psychological status,reducing the risk of postoperative complications,and achieving high nursing satisfaction.These benefits hold promise for a wider application of this technique clinically.