發(fā)布時(shí)間：2018-01-07 13:18

  本文關(guān)鍵詞：肺癌胸腔鏡手術(shù)圍麻醉期安全護(hù)理路徑的編制和實(shí)證研究　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 肺癌胸腔鏡手術(shù) 圍麻醉期 安全護(hù)理路徑

【摘要】：目的制定肺癌胸腔鏡手術(shù)患者圍麻醉期安全護(hù)理路徑文本,評價(jià)肺癌胸腔鏡手術(shù)患者圍麻醉期安全護(hù)理路徑的實(shí)施效果。方法本研究分兩階段進(jìn)行:本研究分兩階段進(jìn)行:(1)參考麻醉科護(hù)理常規(guī)及大量文獻(xiàn),通過咨詢臨床專家及臨床醫(yī)務(wù)人員,設(shè)計(jì)并編制肺癌胸腔鏡手術(shù)患者圍麻醉期安全護(hù)理路徑表和臨床實(shí)施流程。通過三輪預(yù)實(shí)驗(yàn)的實(shí)施,最終確定肺癌胸腔鏡手術(shù)圍麻醉期安全護(hù)理路徑。(2)選取肺癌胸腔鏡手術(shù)患者120例,隨機(jī)分為干預(yù)組和對照組各60例。兩組患者在年齡、性別和ASA分級、臨床分期、手術(shù)時(shí)間等一般資料上的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。對照組采用常規(guī)圍麻醉期護(hù)理,干預(yù)組按照肺癌胸腔鏡手術(shù)患者圍麻醉期安全護(hù)理路徑進(jìn)行護(hù)理。以焦慮水平、躁動(dòng)發(fā)生次數(shù)、鎮(zhèn)痛評分、舒適度評分、操作時(shí)間和住院時(shí)間為評價(jià)指標(biāo),評價(jià)肺癌胸腔鏡手術(shù)圍麻醉期安全護(hù)理路徑的應(yīng)用效果。結(jié)果1.完成肺癌胸腔鏡手術(shù)圍麻醉期安全護(hù)理路徑的文本編制和實(shí)施流程的規(guī)定。文本由患者入院基本信息和圍麻醉期安全護(hù)理路徑表格2個(gè)部分組成,其中安全護(hù)理路徑表格包括麻醉前一日、麻醉日和麻醉后24-48小時(shí)。2.數(shù)據(jù)分析顯示,干預(yù)組患者術(shù)前30分鐘平均焦慮評分(HAD評分)為11.83±2.34,而對照組為17.55±2.73。干預(yù)組明顯比對照組低(t=12.312,P0.001),兩組比較差異有統(tǒng)計(jì)學(xué)意義。干預(yù)組患者躁動(dòng)發(fā)生6例,躁動(dòng)發(fā)生百分率為10.00%,對照組術(shù)后躁動(dòng)發(fā)生17例,躁動(dòng)發(fā)生百分率為28.33%,兩組比較差異明顯,有統(tǒng)計(jì)學(xué)意義(c2=6.508,P0.01)。干預(yù)組患者平均鎮(zhèn)痛評分(VAS評分)為4.18±1.50,對照組為4.82±1.10,兩組比較差異有統(tǒng)計(jì)學(xué)意義(t=2.638,P=0.009)。干預(yù)組患者術(shù)后平均舒適度評分(PCQ評分)為100.92±14.47,對照組為87.58±11.85,干預(yù)組患者平均舒適度評分明顯比對照組高(t=-5.524,P0.001)。干預(yù)組患者術(shù)后平均麻醉插管操作時(shí)間為7.50±2.05分鐘,對照組為9.73±2.33分鐘,干預(yù)組患者平均麻醉插管操作時(shí)間明顯比對照組縮短(t=5.582,P0.001)。干預(yù)組患者術(shù)后平均住院日是9.22±1.54天,對照組為11.62±1.43天,干預(yù)組患者住院時(shí)間比對照組明顯縮短,差異有統(tǒng)計(jì)學(xué)意義(t=8.8500,P0.001)。結(jié)論肺癌胸腔鏡手術(shù)圍麻醉期安全護(hù)理路徑的構(gòu)建為肺癌胸腔鏡手術(shù)患者圍麻醉期安全護(hù)理提供規(guī)范方法。此安全護(hù)理路徑的應(yīng)用能減輕患者焦慮程度及躁動(dòng)發(fā)生并降低疼痛程度,能提高患者舒適程度,并能縮短麻醉誘導(dǎo)插管操作時(shí)間和術(shù)后住院時(shí)間。
[Abstract]:Objective to establish lung cancer patients with thoracoscopic surgery perioperative safety nursing path text, to evaluate the effect of thoracoscopic surgery in patients with lung cancer perioperative nursing safety pathway. Methods this study is divided into two stages: the study is divided into two stages: (1) Department of Anesthesiology nursing routine and reference literature, through consulting experts and clinical the clinical medical personnel, design and preparation of thoracoscopic surgery patients with lung cancer perioperative safety and clinical nursing path table implementation process. Through the implementation of three pre experiment, and ultimately determine the lung cancer thoracoscopic surgery perioperative safety nursing path. (2) a total of 120 cases of lung cancer patients with thoracoscopic surgery, were randomly divided into intervention group and control 60 cases in each group. The two groups in age, gender and ASA classification, clinical stage, there was no significant difference in general data operation time (P0.05). The control group received conventional perioperative nursing, stem The pre group nursing in patients with lung cancer according to thoracoscopic surgery perioperative nursing safety path. To the level of anxiety, restlessness times, pain scores, comfort score, operation time and hospitalization time as the evaluation index, evaluation of thoracoscopic lung surgery application effect of anesthesia nursing safety pathway. Results 1. complete perioperative safety the nursing path for lung cancer thoracoscopic surgery text preparation and implementation of process regulations. Text by the patients basic information and perioperative safety nursing path table is composed of 2 parts, including safety nursing path table including anesthesia the day before anesthesia, and anesthesia after 24-48 hours.2. data analysis showed that the patients in the intervention group before 30 min average anxiety score (HAD score) was 11.83 + 2.34, while the control group was 17.55 + 2.73. group was significantly lower than the control group (t=12.312, P0.001), there was significant difference between two groups. Patients in the intervention group the incidence of agitation in 6 cases, the incidence of agitation was 10%, the control group on postoperative agitation in 17 cases, the incidence of agitation was 28.33%, the difference between the two groups was statistically significant (c2=6.508, P0.01). The average intervention analgesia group score (VAS score) was 4.18 + 1.50, 4.82 in the control group. 1.10, there was significant difference between two groups (t=2.638, P=0.009). The patients in the intervention group after the average score (PCQ score) was 100.92 + 14.47, 11.85 + 87.58 in the control group, patients in the intervention group the average score is significantly higher than the control group (t=-5.524, P0.001). The patients in the intervention group after the average intubation operation time was 7.50 + 2.05 minutes, the control group was 9.73 + 2.33 minutes, patients in the intervention group the average intubation time was significantly shorter than the control group (t=5.582, P0.001). The patients in the intervention group after the average hospitalization days was 9.22 + 1.54 days, the control group was 11.62 Within 1.43 days, the intervention group hospitalization time was significantly shorter than the control group, the difference was statistically significant (t=8.8500, P0.001). The perioperative nursing path construction safety conclusion lung cancer thoracoscopic surgery with standard methods for lung cancer patients with thoracoscopic surgery perioperative nursing safety of anesthesia. Application of the safety nursing pathway can reduce the anxiety degree of patients and the incidence of agitation and reduce pain, improve patients comfort degree, and can shorten the hospitalization time of anesthesia induction and intubation operation time and postoperative.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 孫振曉;劉化學(xué);焦林瑛;周濤;楊洛寧;范金云;;醫(yī)院焦慮抑郁量表的信度及效度研究[J];中華臨床醫(yī)師雜志(電子版);2017年02期

2 蘇鴻莉;李玲霞;高慧;;PCIA及PCPB對肺癌根治術(shù)患者鎮(zhèn)痛效果及免疫功能的影響[J];實(shí)用癌癥雜志;2016年10期

3 梁大干;張干;莫惠飛;駱智宇;;右美托咪定聯(lián)合舒芬太尼在開胸手術(shù)術(shù)后患者靜脈自控鎮(zhèn)痛的應(yīng)用[J];浙江臨床醫(yī)學(xué);2016年07期

4 呂德榮;張景暉;;舒芬太尼聯(lián)合右美托咪定對腹腔鏡手術(shù)患者術(shù)后鎮(zhèn)痛效果的觀察[J];國外醫(yī)學(xué)(醫(yī)學(xué)地理分冊);2016年02期

5 李偉;董彥海;;舒芬太尼輔助嗎啡對老年冠心病患者胸腔鏡腫瘤術(shù)后鎮(zhèn)痛的效果[J];實(shí)用癌癥雜志;2016年02期

6 丁明霞;張興梅;;預(yù)注右美托咪定聯(lián)合氟比洛芬酯用于肺癌根治術(shù)患者的效果觀察[J];臨床肺科雜志;2015年10期

7 高強(qiáng)方;;胸腔鏡肺癌根治術(shù)患者圍術(shù)期疼痛物質(zhì)及炎性介質(zhì)變化研究[J];實(shí)用癌癥雜志;2015年08期

8 陳宇寧;吳祖培;;不同手術(shù)方式治療肺癌的生活質(zhì)量比較[J];中國現(xiàn)代藥物應(yīng)用;2015年14期

9 張健;譚君梅;彭文濤;;全麻手術(shù)患者圍麻醉期舒適狀況及影響因素分析[J];護(hù)士進(jìn)修雜志;2015年14期

10 王江波;;完全胸腔鏡手術(shù)與傳統(tǒng)開胸手術(shù)對早期非小細(xì)胞肺癌患者術(shù)后近期生活質(zhì)量影響的對比研究[J];實(shí)用心腦肺血管病雜志;2015年06期

相關(guān)博士學(xué)位論文 前1條

1 馬爽;手術(shù)及麻醉不良事件與手術(shù)安全核對制度執(zhí)行情況的評估[D];北京協(xié)和醫(yī)學(xué)院;2012年

相關(guān)碩士學(xué)位論文 前10條

1 程艷勤;脊柱手術(shù)患者術(shù)前焦慮因素分析[D];青島大學(xué);2015年

2 韓艷;ICU成人患者經(jīng)口氣管插管自行拔管相關(guān)因素及集束化護(hù)理措施干預(yù)效果研究[D];青島大學(xué);2015年

3 張艷;臨床護(hù)理路徑在腹腔鏡袖狀胃切除減肥術(shù)患者中的應(yīng)用及效果分析[D];延邊大學(xué);2015年

4 祁海鷗;浙江省三級醫(yī)院麻醉恢復(fù)室護(hù)理現(xiàn)狀調(diào)查研究[D];浙江大學(xué);2015年

5 賀盛;肺癌患者開胸行肺葉切除術(shù)術(shù)后拔管延遲的原因分析[D];廣西醫(yī)科大學(xué);2014年

6 孫華君;中美兩國麻醉護(hù)士培養(yǎng)模式的比較研究[D];泰山醫(yī)學(xué)院;2014年

7 蘇丹;家屬同步階段性認(rèn)知療法對肺癌圍手術(shù)期患者應(yīng)激反應(yīng)影響的研究[D];中南大學(xué);2012年

8 彭凌;臨床護(hù)理路徑應(yīng)用于首次腦梗死患者的效果評價(jià)[D];浙江大學(xué);2012年

9 王燕燕;三級綜合醫(yī)院全身麻醉病人對麻醉服務(wù)滿意度水平的研究[D];泰山醫(yī)學(xué)院;2012年

10 王蕾;外科系統(tǒng)護(hù)士對麻醉風(fēng)險(xiǎn)認(rèn)知及影響因素的研究[D];泰山醫(yī)學(xué)院;2012年

，

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