摘要
目的探讨临床路径在基层医院减少麻醉并发症中的应用价值。方法选取2014年5月至2015年6月广东省东莞市石碣医院收治的88例麻醉下行胆囊切除术的胆结石患者作为研究对象,按随机数字表法将其分为观察组和对照组,各44例。观察组患者严格按照临床路径执行麻醉,对照组患者的饮食及护理无特殊规定,均由患者家属负责照料,比较两组患者麻醉效果、麻醉前后生理指标变化情况及麻醉并发症发生情况。结果观察组患者的术后苏醒时间明显短于对照组,术中需追加麻醉比例明显低于对照组,对麻醉效果的满意度明显高于对照组,差异均有统计学意义(均P<0.05);麻醉后,观察组患者的心率(HR)、平均动脉压(MAP)均明显低于对照组,且麻醉后20 min的疼痛视觉模拟量表(VAS)评分显著低于对照组,差异均有统计学意义(均P<0.05);观察组患者心率失常、脑供血不足、低氧血症、血肿、抽搐并发症发生率均明显低于对照组,差异均有统计学意义(均P<0.05)。结论临床路径应用于基层医院外科麻醉中,不仅能有效避免患者麻醉前后生理指标大幅变化,而且能降低麻醉并发症发生,提高患者满意度。
Objective To investigate the application value of clinical pathway in reducing the complication of anesthesia in primary hospital.Methods Selected June may 2014 to 2015,Guangdong Province,Dongguan City Shijie hospital were 88 cases of anesthesia gallbladder resection surgery in patients with gallstones as the object of study,divided into the observation group and the control group according to random number table method,44 cases in each.Observation group were strictly in accordance with the clinical pathway implementation of anesthesia,the control diet and nursing care of patients without special provisions,by the families of patients with responsible for the care of,compared two groups of patients with anesthetic effect,anesthesia and physiological changes and anesthetic complications.Results But the patients in the observation group postoperative recovery time was significantly shorter than the control group,additional anesthesia was significantly lower than that of the patients in the control group,the anesthesia effect of satisfaction was significantly higher than the control group,the differences were statistically significant（P〈0.05）;after anesthesia,the observation group of patients with heart rate,mean arterial pressure were significantly lower than the control group,pain visual analogue scale and 20 min after anesthesia were significantly lower than the control group,the differences were statistically significant（P〈0.05）;the observation group of patients with arrhythmia,cerebral ischemia,hypoxia,blood swelling and convulsion complication rate were significantly lower than control group.The differences were statistically significant（P〈0.05）.Conclusions Application of clinical pathway in primary hospital surgical anesthesia,not only can effectively avoid patients with significant changes in physiological indexes before and after anesthesia,and can reduce the incidence of anesthesia complications,improve patient satisfaction.
出处
《中国药物经济学》
2016年第6期109-112,共4页
China Journal of Pharmaceutical Economics
基金
2014年广东省东莞市科技局医学科研项目
编号:2014105101211
关键词
临床路径
基层医院
麻醉
并发症
Clinical pathway
Primary hospital
Anesthesia
Complications
