摘要
目的:探讨胃癌围手术期患者肺部并发症发生的相关影响因素,并分析其护理防控策略。方法:回顾分析390例行胃癌切除术的患者,其中发生肺部并发症58例,设为观察组,其余332例患者设为对照组。结果:比较两组年龄、合并症、NRS营养评分、放化疗史、开放手术、全胃切除、联合器官切除、使用喉镜插管、术中安置胃管,差异均有统计学意义(均P<0.05);对两组患者采用保护性通气策略、术毕进行气管导管吸痰、切口浸润麻醉、家属或护士协助排痰、鼓励患者术后6~24h在床上活动或早期下床、进行咳嗽训练、术后口腔护理、术后雾化治疗和术后使用镇痛泵情况进行比较,差异均有统计学意义(P<0.05)。结论:胃癌围手术期肺部并发症与患者自身状况、放化疗史、手术状况及术后体位、咳嗽训练、口腔护理、雾化治疗及适当伤口镇痛方案密切相关,对于围手术期患者应加强对原发疾病、呼吸道、术后体位等护理,降低其肺部并发症发生率。
Objective:To explore the related factors of pulmonary complications in patients with gastric cancer during perioperative period,and to analyze the nursing prevention and control strategies.Methods:By retrospective survey approach,390 gastric cancer patients with perioperative period were selected,including 58 pulmonary complications patients as the observation group and the remaining 332 patients as the control group.Results:The age,complications,NRS nutritional score,history of radiotherapy and chemotherapy,open surgery,total gastrectomy,combined organ resection,laryngoscopic intubation and intraoperative placement of gastric tube were compared between the two groups,and the differences were statistically significant ( P <0.05).There were significant differences between the two groups in using protective ventilation strategy,endotracheal tube sputum aspiration after operation,incision infiltration anesthesia,family members or nurses assisting sputum expectoration,encouraging patients to move in bed or get out of bed early 6-24 h after operation,cough training,oral nursing after operation,post-operative atomization therapy and post-operative use of analgesic pump ( P <0.05).Conclusion:Perioperative pulmonary complications of gastric cancer are closely related to the patient's own condition,history of radiotherapy and chemotherapy,operation status and posture after operation,cough training,oral nursing,atomization therapy and appropriate wound analgesia program.Perioperative patients should strengthen the nursing of primary diseases,respiratory tract,posture after operation,so as to reduce the incidence of pulmonary complications.
作者
翟晓清
杨婕
蒋理立
ZHAI Xiao-qing;YANG Jie;JIANG Li-li(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)
出处
《川北医学院学报》
CAS
2019年第3期484-487,共4页
Journal of North Sichuan Medical College
关键词
胃癌
手术
肺部并发症
影响因素
护理
Gastric cancer
Surgery
Pulmonary complications
Influencing factors
Nursing
