多维危机控制理念在老年腹腔镜胆囊切除术患者麻醉苏醒期的应用

Application of multi⁃dimensional crisis control concept in elderly patients undergoing laparoscopic cholecystectomy during an⁃esthesia recovery

目的 观察多维危机控制理念在老年腹腔镜胆囊切除术(LC)患者麻醉苏醒期的应用效果。方法 选取2020年6月—2022年6月西南医科大学附属成都三六三医院犀浦院区收治的107例老年LC患者,以随机数表法分成观察组(n=54)与对照组(n=53),给予对照组患者常规护理,观察组患者则在对照组的基础上予以多维危机控制理念护理模式。观察2组生理指标[心率(HR)、平均动脉压(MAP)]、复苏情况、疼痛评分(VAS)以及术后麻醉相关不良反应的发生情况。结果 观察组HR与MAP水平显著低于对照组,差异有统计学意义(P<0.05),同时观察组患者的PACU定向力恢复时间及PACU停留时间均显著低于对照组,差异有统计学意义(P<0.05)。离开PACU时,观察组VAS评分显著低于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率为3.70%,显著低于对照组的16.98%,差异有统计学意义(P<0.05)。结论 多维危机控制理念有利于维持老年LC患者麻醉苏醒期的血流动力学,能缩短复苏时间,同时能改善患者的疼痛程度,并减少术后麻醉相关不良反应的发生率,具有推荐价值。

Objective To observe the application effect of multi⁃dimensional crisis control concept in elderly patients undergoing laparoscopic cholecystectomy(LC)during anesthesia recovery.Methods A total of 107 elderly patients with LC admitted to Xipu Branch of Chengdu 363 Hospital Affiliated to Southwest Medical University from June 2020 to June 2022 were selected and divided into observation group(n=54)and control group(n=53)by random number table method.The control group was given routine nursing,and the observation group was given nursing under the guidance of multi⁃dimensional crisis control concept on the basis of the control group.Physiological indexes[heart rate(HR)and mean arterial pressure(MAP)],resuscitation status,pain[Visual Analogue Scale(VAS)]score and postoperative anesthetic⁃related adverse reactions were ob⁃served in the two groups.Results HR and MAP of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05).The recovery time of orientation and residence time in PACU of the observation group were significantly shorter than those of the control group,and the difference was statistically significant(P<0.05).When leaving PACU,VAS score of the observation group was significantly lower than that of the control group,with a statistically significant difference(P<0.05).The total incidence of adverse reactions in the observation group was signifi⁃cantly lower than that in the control group,with a statistically significant difference(3.70%vs 16.98%,P<0.05).Conclu⁃sion The multi⁃dimensional crisis control concept is beneficial to maintain hemodynamics in elderly LC patients during anes⁃thesia recovery period.It can shorten the resuscitation time,relieve pain and reduce the incidence of postoperative anesthesia⁃related adverse reactions,and has recommended value.