摘要
目的探讨操作抓钳与护理人员自制伸缩注射装置分别用于胸腔镜肺叶切除术中创面止血方法的临床效果。方法60例胸腔镜肺叶切除术治疗患者根据手术日期先后分成操作抓钳组和伸缩注射装置组各30例，创面止血分别给予操作抓钳夹取止血粉和止血粉倒入伸缩注射装置进行创面止血处理及预防性治疗，比较2组术中器械送人内镜时间、止血粉完全覆盖创面时间、器械撤离内镜时间、单次止血粉创面覆盖率、创面再出血率、再次安装止血粉末发生率情况。结果2组器械送入内镜时间、器械撤离内镜时间比较差异无统计学意义（P〉0．05）。伸缩注射装置组止血粉完全覆盖创面时间为（24．90±5．90）S，短于操作抓钳组的（55．60±25．60）S，差异有统计学意义（t=6．401，P〈0．01）。伸缩注射装置组单次止血粉创面覆盖率为86．67％（26／30），较操作抓钳组的76．67％（23／30）高，差异有统计学意义（x2=2．016，P〈0．05）；操作抓钳组创面再出血率为33．33％（10／30），高于伸缩注射装置组的10．00％（3／30），差异有统计学意义（x2=4．812，P〈0．05）。操作抓钳组再次安装止血粉末发生率为93．3％（28／30），伸缩注射装置组为10．0％（3／30），2组比较差异有统计学意义（x2=41．713，P〈0．01）。结论护理人员自制伸缩注射装置协助手术者进行胸腔镜肺叶切除术时进行创面止血并预防再出血，创面覆盖率高于操作抓钳，完全覆盖创面时间比操作抓钳少，再次安装止血粉末发生率低，整个过程缩短手术操作时间。可在临床推广。
Objective To explore the operation of grasping forceps and nursing staff made telescopic injection device were used for the clinical effect of Hemostasises thoracoscopic lobectomy. Methods 60 cases of thoracoscopic lobectomy for patients according to the date of surgery were divided into operation group and telescopic grasping forceps injection device group 30 patients were given hemostasia operation grasping forceps extraction hemostatic powder and hemostatic powder into the injection device for telescopic wound hemostasis treatment and preventive treatment, were compared between the two groups in the instrument body, completely hemostatic powder cover the wound time, evacuation time of endoscopic instruments, single hemostatic powder wound coverage, wound bleeding rate, the incidence of bleeding again installed. Results The telescopic injection device group and operation time grasping forceps group into cavity instruments, endoscopic evacuation equipment time showed no significant difference （P〉0.05）. Hemostatic powder completely cover the wounds of time （24.90 ＋ 5.90） s and （55.60 ＋ 25.60） s, there was significant difference between two groups （t=6.401, P〈0.01）. The single ended wound coverage of blood meal was 86.67% （26/30） and 76.67% （23/30）, there was significant difference between two groups （x2=2.016, P〈0.05）. Wound bleeding rate was 10.00%（3/30） and 33.33%（10/30）, there was statistically significant difference between the two groups （x2=4.812, P〈0.05）. The incidence of bleeding again to install powder was 10.0%（3/30） and 93.3%（28/30）, there was significant difference between two groups （x2=41.713, P 〈0.01）. Conclusions The nursing staff made telescopic injection device assisted surgery were thoracoscopic lobectomy of the wound to stop bleeding and prevent rebleeding, wound coverage than grasping forceps, completely cover the wound operation less time than grasper, re install a low incidence of hemostatic powder, the whole process to short
作者
朱彩玲
陈芳
俞丽美
庄新萍
Zhu Cailing Chen Fang Yu Limei Zhuang Xinping.(Department of Operation Room, Yixing People＇ s Hospital, Affiliated to Jiangsu University, Yixing 214200, China)
出处
《中国实用护理杂志》
2017年第26期2048-2051,共4页
Chinese Journal of Practical Nursing
