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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 373 -376. doi: 10.3877/cma.j.issn.1674-392X.2019.04.023

所属专题： 文献；

护理园地

全程干预在高龄腹股沟疝合并慢性阻塞性肺疾病围手术期的应用
张星星1,†(), 翟怀香1   
  1. 1. 222000　江苏省，连云港市第一人民医院重症医学科
  • 收稿日期:2019-02-09 出版日期:2019-08-18
  • 通信作者: 张星星

Application of the value of whole intervention in elderly patients with inguinal hernia complicated with chronic obstructive pulmonary disease during perioperative period

Xingxing Zhang1,†(), Huaixiang Zhai1   

  1. 1. Department of Intensive Care Uni, Lianyungang first People's Hospital, Lianyungang 222000, China
  • Received:2019-02-09 Published:2019-08-18
  • Corresponding author: Xingxing Zhang
  • About author:
    Corresponding author: Zhang Xingxing, Email:
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张星星, 翟怀香. 全程干预在高龄腹股沟疝合并慢性阻塞性肺疾病围手术期的应用[J]. 中华疝和腹壁外科杂志(电子版), 2019, 13(04): 373-376.

Xingxing Zhang, Huaixiang Zhai. Application of the value of whole intervention in elderly patients with inguinal hernia complicated with chronic obstructive pulmonary disease during perioperative period[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(04): 373-376.

目的

探究全程干预在高龄腹股沟疝合并慢性阻塞性肺疾病围手术期的应用。

方法

选取2017年8月至2018年8月，连云港市第一人民医院收治的围手术期高龄腹股沟疝合并慢性阻塞性肺疾病患者50例，根据随机数字法，分为全程干预组及常规护理2组，每组25例。护理前及护理后记录2组患者体温、氧合指数及APACHEⅡ评分。护理后统计2组患者并发症的发生率、肺部感染率及护理满意率。

结果

护理前后2组患者的体温与组间体温比较，差异均无统计学意义（P>0.05）。氧合指数较护理前明显升高，且全程护理组患者的氧合指数显著高于常规护理组，2组患者的APACHEⅡ评分与护理前相比均显著下降，且全程干预患者APACHEⅡ评分明显低于常规护理组，差异均有统计学意义（P<0.05）。全程干预组肺部感染率8.00%明显低于常规护理组32.00%，全程干预组患者的护理满意度92.00%显著高于常规护理组68.00%，差异均有统计学意义（P<0.05）。

结论

全程干预在高龄腹股沟疝合并慢性阻塞性肺疾病患者围手术期的应用可降低患者术后肺部感染率的发生，促进术后恢复。

关键词: 疝，腹股沟, 慢性阻塞性肺疾病, 高龄患者, 并发症, 全程干预
Objective

To explore the application of whole intervention in the perioperative period of elderly inguinal hernia complicated with chronic obstructive pulmonary disease (COPD).

Methods

50 patients with perioperative inguinal hernia complicated with COPD from August 2017 to August 2018 were admitted to ICU in Lianyungang first people's Hospital. According to random number method, the patients were divided into the whole intervention nursing group and the routine nursing group, 25 cases in each group. Body temperature, oxygenation index and APACHE Ⅱ score were recorded before and after nursing care. The incidence of postoperative complications, pulmonary infection rate and nursing satisfaction rate were counted after nursing care in the two groups.

Results

There was no significant difference in body temperature between the two groups before and after nursing care. (P>0.05). The oxygenation index was significantly higher than that before, and the oxygenation index in the whole process intervention group was significantly higher than that in the routine nursing group. The scores of APACHE Ⅱ in both groups were significantly lower than those before nursing. The score of APACHE Ⅱ in the whole process intervention group was significantly lower than that in the routine nursing group (P<0.05). The incidence of pulmonary infection in the whole process intervention group 8.00% was significantly lower than that in the routine nursing group 32.00%. The rate of nursing satisfaction was 92.00% in the whole process intervention group and 68.00% in the routine nursing group.

Conclusion

The application of whole intervention in the perioperative period of elderly patients with inguinal hernia complicated with COPD can reduce the incidence of postoperative pulmonary infection and promote postoperative recovery, which is worthy of clinical application.

Key words: Hernia, inguinal hernia, Chronic obstructive pulmonary disease, Elderly patients, Complications, Whole intervention
表1 2组患者体温、氧合指数及APACHEⅡ评分比较（±s）
组别 时间 例数 体温(℃) 氧合指数 APACHEⅡ评分(分)
全程干预组 护理前 25 38.41±1.60 170.90±82.61 22.89±8.31
护理后 25 37.21±1.22 259.41±95.82*△ 14.19±4.21*△
常规护理组 护理前 25 38.62±1.01 172.22±81.50 22.53±8.29
护理后 25 37.81±1.32 215.19±90.45* 16.45±4.29*
表2 2组患者护理满意度的比较[例（%）]
组别 例数 满意 基本满意 不满意 满意率%
全程干预组 25 15(60.00) 10(40.00) 2(8.00) 23(92.00)△
常规护理组 25 7(28.00) 10(40.00) 8(32.00) 17(68.00)
[1]
Huerta S, Pham T, Foster S, et al. Outcomes of emergent inguinal hernia repair in veteran octogenarians[J]. Am Surg, 2014, 80(5): 479-483.
[2]
Gawad N, Davies DA, Langer JC. Determinants of wait time for infant inguinal hernia repair in a Canadian children' s hospital[J]. J Pediatr Surg, 2014, 49(5): 766-769.
[3]
唐健雄, 李绍杰, 黄磊. 我国腹股沟疝手术规范化和质量控制存在的问题及对策[J]. 中国实用外科杂志, 2018, 38(1): 72-74.
[4]
王玮, 王琦, 吴海斌, 等. COPD肺络微型癥瘕的分子病理学阐释[J]. 环球中医药, 2016, 9(8): 946-949.
[5]
叶钢. MEWS评分与APACHEⅡ评分预测重症医学科患者病情的比较[J]. 中国医药导刊, 2016, 18(7): 690-690.
[6]
孟发蓉, 刘桂芬, 白艾灵. 全期护理对老年手术患者术中生理应激及护理满意度的影响[J]. 检验医学与临床, 2017, 14(11): 1643-1644.
[7]
Hao AT, Wu LP, Kumar A, et al. Nursing process decision support system for urology ward[J]. Int J Med Inform, 2013, 82(7): 604-612.
[8]
Hammond CB. Care of patients undergoing day case inguinal hernia repair[J]. Nurs Stand, 2014, 28(31): 53-60．
[9]
谢青路. 手术室优质护理中应用全程无缝护理模式的可行性研究[J]. 护士进修杂志, 2017, 32(8): 706-708.
[10]
魏莉. 预见性护理对ICU多发伤患儿疼痛与焦虑的效果观察[J]. 贵州医药, 2017, 41(11): 1223-1224.
[11]
李萌. 腹腔镜治疗老年腹股沟疝患者的围手术期护理[J]. 腹腔镜外科杂志, 2016, 12(2): 136-136.
[12]
Udofot SU. Multiple faecal and urinary fistulae as a complication of native treatment of inguinal hernia[J]. Trop Geogr Med, 2016, 43(1/2): 105-107.
[13]
孙丽, 黄惠雪, 白雪, 等. 肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响[J]. 中国康复医学杂志, 2016, 31(4): 434-438.
[14]
孟志刚, 佘瑞芳, 姚彬. 持续肺康复训练对保持COPD患者肺康复治疗后运动能力和生活质量的影响[J]. 中国呼吸与危重监护杂志, 2017, 23(18): 133-136.
[15]
应少聪, 周向东, 周丽华, 等. 运动训练联合心理激励对慢性阻塞性肺疾病患者生活质量的影响[J]．南方医科大学学报, 2013, 33(9): 1312-1315．
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