CAJ | 학술논문

目的探讨心理干预对中老年全麻病人导尿术后麻醉苏醒期躁动的影响.方法选择60例气管插管全麻下行开胸手术病人,随机分为3组,每组各20例.Ⅰ组20例是在手术晨病人清醒状态下行导尿术.Ⅱ组20例是在病人全麻后行导尿术,Ⅲ组20例是在病人进入手术间后,由巡回护士对病人进行心理干预,讲解麻醉前、后插尿管的情况,及麻醉后留置尿管的优点及必要性,并详细解释留置尿管后,在麻醉苏醒过程中因尿管刺激而存在不适等.取得病人的理解和合作后,在麻醉后行导尿术.观察各组病人安置尿管时的心率、血压变化,一次性置管成功率以及麻醉苏醒期病人躁动等情况.结果 Ⅰ组:心率、血压均明显增加,一次性置管成功率80%(P<0.05),麻醉苏醒躁动分值及导管脱出率无显著性差异(P>0.05).Ⅱ组:心率、血压平稳,一次性置管成功率100%(P>0.05),麻醉苏醒躁动分值及导管脱出率增加(P<0.01).Ⅲ组:各项指标变化无显著性差异(P>0.05).结论心理干预可以明显减轻中老年全麻导尿病人苏醒期躁动,而且在麻醉后行导尿术,可提高导尿的成功率,减轻病人的痛苦,体现出"一切为了病人"和"以病人为中心"的服务宗旨.
목적 탐토심리간예대중노년전마병인도뇨술후마취소성기조동적영향.방법 선택60례기관삽관전마하행개흉수술병인,수궤분위3조,매조각20례.Ⅰ조20례시재수술신병인청성상태하행도뇨술.Ⅱ조20례시재병인전마후행도뇨술,Ⅲ조20례시재병인진입수술간후,유순회호사대병인진행심리간예,강해마취전、후삽뇨관적정황,급마취후류치뇨관적우점급필요성,병상세해석류치뇨관후,재마취소성과정중인뇨관자격이존재불괄등.취득병인적리해화합작후,재마취후행도뇨술.관찰각조병인안치뇨관시적심솔、혈압변화,일차성치관성공솔이급마취소성기병인조동등정황.결과 Ⅰ조:심솔、혈압균명현증가,일차성치관성공솔80%(P<0.05),마취소성조동분치급도관탈출솔무현저성차이(P>0.05).Ⅱ조:심솔、혈압평은,일차성치관성공솔100%(P>0.05),마취소성조동분치급도관탈출솔증가(P<0.01).Ⅲ조:각항지표변화무현저성차이(P>0.05).결론 심리간예가이명현감경중노년전마도뇨병인소성기조동,이차재마취후행도뇨술,가제고도뇨적성공솔,감경병인적통고,체현출"일절위료병인"화"이병인위중심"적복무종지.
Objective To investigate the effect of psychological intervention on the restlessness in elderly patients in anesthesia recovery period after the inducement of urethral catheterization. Methods 60 patients, undergoing general anesthesia trachea intubation for open chest operation, were randomly allocated to three groups. 20 patients for each. In the first group, 20 patients were catheterized before the inducement of general anesthesia;In the second group, catheter was inserted after the inducement of general anesthesia. Whereas the patients in the third group were received psychological intervention by circuit nurses after entering the operation room. The patients were given detail explanations of catheterization before and after the inducement of general anesthesia , of the advantages and necessity of intubations after anesthesia, and of the discomfort of intubations during the anesthesia recovery period because of the catheter stimulation. With the understanding and cooperation of the patients, catheter was inserted after the inducement of general anesthesia. Of all the three groups, the heart rate and the blood pressure after urethral catheterization, the success rate of catheterization and the restlessness in the recovery period of general anesthesia were closely observed. Results In the first group, the heart rate and the blood pressure were both obviously increased;the success rate of catheterization was 80% (P<0.05) .the restlessness and the rate of catheter pulling - off were no significant difference ( P > 0.05) .In the second group, both the heart rate and the blood pressure were stable;the success rate of catheterization was 100% ( P > 0.05 ) ;but the restlessness and the rate of catheter pulling - off were increased ( P < 0. 01) .In the third group, there was no significant difference in all the items above (P >0. 05) . Conclusions Psychological intervention can obviously ease the restlessness in recovery period of general anesthesia in elderly patients with the catheter inserted;moreover, the inducement of catheterization after anesthesia can enhance the success rate of catheterization and alleviate the pain of patients, representing the patient - centered service tenet.