基于管道风险评估的缩减约束对食管癌术后胃肠减压患者非计划性拔管及局部皮肤损伤的影响

Evaluation of Reduced Restraint Scheme Based on Pipeline Risk Assessment in Reducing Unplanned Extubation and Local Skin Injury in Patients with Gastrointestinal Decompression after Esophageal Cancer Surgery

目的探讨基于管道风险评估下的缩减约束方案对降低食管癌术后胃肠减压患者非计划性拔管的价值及其对皮肤损伤的影响。方法选取河南省人民医院胸外科2021年1月至2022年10月食管癌手术行胃肠减压的患者110例,按随机数字表法分为对照组和干预组。对照组55例给予实施常规护理方案,干预组55例加以基于管道风险评估量表的缩减约束方案。对比两组患者非计划性拔管发生率、心理状态、皮肤损伤情况以及约束相关并发症发生情况。结果干预后,干预组的SCL-90量表各维度及总分均低于对照组(P<0.05),两组皮肤损伤发生率比较差异无统计学意义(P>0.05),干预组非计划拔管率低于对照组(P<0.05),两组约束相关并发症发生率比较差异无统计学意义(P>0.05)。结论基于管道风险评估下的缩减约束方案能降低患者非计划拔管情况,改善患者的心理状态。

Objective To investigate the value of reduced restraint program based on pipeline risk assessment in reducing unplanned extubation in patients with gastrointestinal decompression after esophageal cancer surgery and its impact on skin injury.Methods 110 patients with esophageal cancer undergoing gastrointestinal decompression from January 2021 to October 2022 in our department were randomly divided into control group and intervention group.55 cases in the control group were given routine nursing plans,while 55 cases in the intervention group were given a reduced constraint plan based on the pipeline risk assessment scale.The incidence of unplanned extubation,psychological state,skin injury and restraintrelated complications were compared between 2 groups.Results After intervention,the dimensions and total scores of SCL90 scale in intervention group were lower than those in control group(P<0.05).There was no statistical significance in the incidence of skin injury between 2 groups(P>0.05).The rate of unplanned extubation in the intervention group was lower than that in the control group(P<0.05),and there was no statistical significance in the incidence of constraintrelated complications between the two groups(P>0.05).Conclusion The reduced restraint program based on the pipeline risk assessment can reduce the unplanned extubation and improve the psychological state of patients with gastrointestinal decompression.