CAJ | 학술논문

目的探讨护理干预对硬膜外自控镇痛(PCEA)不良反应的影响.方法选择2006-2007年进行腹部手术后行PCEA的患者258例,采用前后对照的方法 ,2006年1-12月未实施护理干预的126例患者为对照组,2007年1-12月实施护理干预的132例患者为实验组.对照组主要由麻醉师管理,护士只进行常规的护理指导,实验组除常规护理指导外,同时实施系统、规范的护理干预,即进行心理干预、认知干预、行为干预、严密观察、及时发现不良反应并早期处理.观察2组患者发生尿潴留、恶心呕吐、腹胀、皮肤压痕、导管脱落、皮肤瘙痒、下肢麻木、呼吸抑制等PCEA不良反应的发生率并进行比较.结果实验组恶心呕吐、腹胀、排尿障碍、导管脱落、皮肤压痕等PCEA不良反应的发生率明显低于对照组,差异显著.结论实施护理干预能降低腹部手术后PCEA的不良反应,减轻患者的痛苦,促进术后功能恢复和机体康复.
목적 탐토호리간예대경막외자공진통(PCEA)불량반응적영향.방법 선택2006-2007년진행복부수술후행PCEA적환자258례,채용전후대조적방법 ,2006년1-12월미실시호리간예적126례환자위대조조,2007년1-12월실시호리간예적132례환자위실험조.대조조주요유마취사관리,호사지진행상규적호리지도,실험조제상규호리지도외,동시실시계통、규범적호리간예,즉진행심리간예、인지간예、행위간예、엄밀관찰、급시발현불량반응병조기처리.관찰2조환자발생뇨저류、악심구토、복창、피부압흔、도관탈락、피부소양、하지마목、호흡억제등PCEA불량반응적발생솔병진행비교.결과 실험조악심구토、복창、배뇨장애、도관탈락、피부압흔등PCEA불량반응적발생솔명현저우대조조,차이현저.결론 실시호리간예능강저복부수술후PCEA적불량반응,감경환자적통고,촉진술후공능회복화궤체강복.
Objective To explore impact of nursing intervention on the adverse reaction of patient con-trol epidural analgesia (PCEA) after abdominal operation. Methods 258 patients underwent PCEA after ab-dominal operation were selected from 2006 to 2007. The clinical data of 126 patients without nursing interven-tion were analyzed as the control group admitted to our hospital from January to December, 2006 and compared with those of 132 patients receiving nursing intervention as the experimental group from January to December, 2007. The control group was managed by the anesthetists and nurses only conducted routine nursing instruction, while the experimental group was given systematic and normative nursing intervention besides routine nursing instructions, including psychological intervention, behavioral intervention, close observation, of discovery of ad-verse reaction in time and giving early disposal. The incidence of adverse reaction of PCEA of the two groups such as urinary retention, nausea and vomiting, abdominal distension, skin indentation, catheter shedding, skin itching, numbness of lower limbs, respiratory depression was observed. Results Compared with the control group,the incidence of adverse reactions of PCEA in the experimental group such as urinary retention,nansea and vomiting, abdominal distension,skin indentation,catheter shedding was significantly lower. Conclusions The implementation of nursing intervention can reduce the adverse reaction of PCEA after abdominal operation, alle-viate the suffering of patients, and promote functional recovery and the body rehabilitation.