摘要
目的分析胸腔镜下肺段切除术后护理的特殊性并改进护理方案。方法选择2015年9月1日—2016年8月31日,在厦门大学附属成功医院胸外科行胸腔镜下单操作孔单肺叶切除或单肺段切除术的60例患者,将肺叶切除术后的护理方案定义为常规护理,将肺段切除术后改进的护理方案定义为特殊护理,根据手术方法和护理方案将患者分为三组。①肺叶切除常规护理组(n=18);②肺段切除常规护理组(n=21);③肺段切除特殊护理组(n=21)。特殊护理措施是指在常规护理方案的基础上,强化术后呼吸道护理、延长拔胸管时间、术后不适指数评估与充分止痛。比较三组患者术后胸腔引流量、并发症发生率、不适指数、住院天数等指标的差异。结果三组患者的平均年龄、性别构成、手术时间、术中出血量、术后胸腔引流量比较,差异均无明显统计学差异(P>0.05)。肺段切除常规护理组术后第1、5天的不适指数显著高于肺叶切除常规护理组和肺段切除特殊护理组,差异均有统计学意义(P≤0.01);但三组间术后第3天的不适指数比较差异无统计学意义(P>0.05)。肺段切除常规护理组的术后住院时间显著高于肺叶切除常规护理组和肺段切除特殊护理组,差异均有统计学意义(P<0.05)。结论因手术术式的不同,胸腔镜下肺段切除术后护理与肺叶切除术相比有其特殊性,通过改进的护理方案,可减少术后并发症、减轻术后不适和缩短住院时间。
Objective To analyze the particularity of the nursing care after thoracoscopic pulmonary segment resection,propose the improved nursing scheme and demonstrate its effect.Methods 60 patients who underwent single-utility-port single-lobectomy or single-segmentectomy of thoracoscopic surgery from September 1,2015 to August 31,2016 at the Affiliated Hospital of Xiamen University were divided into 3 groups according to surgery method and nursing scheme.The nursing scheme for lobectomy and segmentectomy were defined as common nursing and special nursing,respectively.Group 1 included 18 patients who underwent lobectomy surgery and received common nursing;group 2 included 21 patients who underwent segmentectomy surgery and received common nursing;group 3 included 21 patients who underwent segmentectomy surgery and received special nursing.The special nursing measures refer to enhanced postoperative respiratory care,prolonged chest-tube removal time,postoperative discomfort index assessment and adequate pain relief.The differences in postoperative chest drainage volume,complication rate,discomfort index,and days of hospital stay were compared among the three groups.Results There was no significant difference in the average age,gender composition,operation time,intraoperative blood loss,postoperative chest drainage volume among the three groups（P〈0.05）.The discomfort index on the 1st and 5th day after operation in the group 2 was significantly higher than that in the other groups.However there was no significant difference of the discomfort index on the 3rd day among the 3 groups.But postoperative hospital stay time of group 2 was longer than that of the other groups.Conclusions Due to different surgical operations,there are some special features in the postoperative nursing between segmentectomy and lobectomy.The improved nursing scheme can reduce postoperative complications,reduce postoperative discomfort and shorten hospital stay.
作者
刘敏
袁源
郭明
Liu Min;Yuan Yuan;Guo Ming(Department of Thoracic Surgery,The Success Hospital Affiliated Xiamen University,Xiamen 361000,China)
出处
《中华胸部外科电子杂志》
2018年第2期113-117,共5页
CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition
基金
南京军区医学科技创新课题(15DXO15)
关键词
胸腔镜下肺段切除术
术后护理
疼痛评估法
不适指数
住院时间
Thoracoscopic pulmonary segment resection
Postoperative care
Pain assessment
Discomfort index
Hospital stay time
