手术室护理干预在预防胃肠道手术切口感染中的应用效果

(整期优先)网络出版时间:2022-11-09
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手术室护理干预在预防胃肠道手术切口感染中的应用效果

王耀辉,廖家兴

西南医科大学附属中医医院 四川泸州 646000

【摘要】目的:探讨手术室护理干预在预防胃肠道手术切口感染中的应用效果。方法:选择2021年3月-2022年3月我院60例胃肠道手术患者作为对象,随机数字表分为对照组(n=30)和观察组(n=30)。对照组患者采用常规护理,观察组患者采用手术室护理。比较两组患者手术指标(手术时间、术后排气时间、术后排便时间和住院时间)、并发症发生情况。结果:观察组手术时间、术后排气时间、术后排便时间和住院时间显著低于对照组( P <0.05);观察组并发症发生率低于对照组( P <0.05)。结论:综上所述,手术室护理应用于胃肠道手术患者后降低了患者切口感染的发生,促进了患者术后排气和排便,缩短了手术时间和住院时间,值得推广应用。

【关键词】手术室护理干预;胃肠道手术;切口感染;应用效果

       胃肠道手术主要是治疗胃肠道组织疾病,主要包括胃大部切除术,胃黏膜修补术,肠癌根治术,部分肠道切除术,肠黏膜修补术等。目前,胃肠道术后容易出现切口感染,会出现肿胀、发红、发热等症状,严重时还会出现脓毒血症、感染性休克、和多器官功能障碍综合征等并发症,严重的影响了患者的手术质量和生命安全,同时也为家庭和社会带来沉重的经济负担[1]。而术后出现切口感染的发生原因主要与无菌技术执行不严格以及手术器械操作不当等有关。因此,应对胃肠道手术患者采取有效的护理干预。手术室护理可以深化手术室专业内涵,加强无菌技术,普及手术器械的操作,以及全面落实护理职责,应用于胃肠道手术患者中有利于预防患者切口感染,促进患者病情恢复。本研究对胃肠道手术患者应用手术室护理干预取得良好效果,报道如下。

1.资料与方法

1.1临床资料

选择2021年3月-2022年3月我院60例胃肠道手术患者作为对象,随机数字表分为对照组(n=30)和观察组(n=30)。对照组30例,男16例,女14例,年龄为(28-77)岁,平均年龄为(52.47±3.28)岁;观察组30例,男17例,女13例,年龄为(27-75)岁,平均年龄为(52.13±3.26)岁。两组临床资料无显著性差异(P>0.05),具有可比性。

1.2方法

对照组:采用常规护理。术后严密观察生命体征生命体征。

观察组:采用手术室护理。(1)做好术前访视和术后回访,询问患者家族病史、过往病史、过敏情况、身体检查的指标还有化验的各项结果,做好术前诊断和准备,告知患者及家属手术流程等相关事宜;(2)术前与患者进行交流沟通,告知患者手术方式,提醒患者手术前需注意的事项,缓解患者术前焦虑等不良情绪;(3)叮嘱患者在术后要注意手术切口的卫生,按时进行手术切口的消毒处理,避免有细菌感染的现象出现;(4)手术室环境管理:手术严格遵循先清洁、后污染的原则,在手术间隔期间严格消毒空气和地面,严格控制室内温度及湿度;(5)严格执行无菌操作:手术室护理人员必须严格遵守无菌操作原则,除参加手术及有关工作人员外,其他人员不准入内,并且手术室一切器械物品未经负责人许可,不得外借,以确保手术所需及防止交叉感染。

1.3观察指标

(1)比较两组患者手术指标,包括手术时间、术后排气时间、术后排便时间和住院时间[2]。(2)比较两组患者并发症发生情况,包括切口感染、伤口延迟愈合、胃肠道运动障碍。

1.4统计分析

采用SPSS22.0软件处理,统计数据线χ2检验,采用n(%)测量数据线t检验,采用()表示,P<0.05差异有统计学意义。

2结果

2.1两组患者手术指标比较

观察组手术时间、术后排气时间、术后排便时间和住院时间显著低于对照组( P <0.05),见表1。

表1两组患者手术指标比较

组别

例数

手术时间(h)

术后排气时间(d)

术后排便时间(d)

住院时间(d)

对照组

30                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        

1.39±0.35

2.72±0.34

3.52±0.31

14.48±4.12

观察组

30

1.22±0.23

1.35±0.41

2.21±0.43

10.24±3.50

t

/

2.695

3.441

4.012

5.071

P

/

<0.05

<0.05

<0.05

<0.05

 2.2两组患者并发症发生情况比较

观察组并发症发生率低于对照组( P <0.05),见表2。

表2两组患者并发症发生情况比较[n,(%)]

组别

例数

切口感染

伤口延迟愈合

胃肠道运动障碍

并发症发生率(%)

对照组

30                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        

4(13.33)

3(10.00)

4(13.33)

11(36.67)

观察组

30

0(0.00)

1(3.33)

1(3.33)

3(6.67)

X2

/

5.225

P

/

<0.05

3 讨论

        目前,胃肠道手术相比较其他手术类型具有较高的切口感染率,不仅会影响疾病的恢复,产生不必要的并发症,还会让患者出现焦虑、抑郁等不良心理负担,因此需要对其进行有效的护理干预[3]。       

本研究对我院胃肠道手术患者实施手术室护理服务干预,可有效的降低切口感染的发生。结果显示护理后观察组手术时间、术后排气时间、术后排便时间和住院时间显著低于对照组并且观察组患者护理后并发症发生率低于对照组,说明手术室护理有利于降低胃肠道手术患者切口感染的发生,促进患者术后排气和排便,缩短患者手术时间和住院时间。手术室护理是指手术室护理人员以手术患者、手术医生为中心,强化服务意识,深化手术室护理专业内涵,全面落实护理职责,为手术患者实施术前访视、术中关爱、术后随访的围手术期责任制护理,应用于胃肠道手术患者中具有较好的护理效果[4]

       综上所述,手术室护理应用于胃肠道手术患者后降低了患者切口感染的发生,促进了患者术后排气和排便,缩短了手术时间和住院时间,值得推广应用。

参考文献

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[2]李艳伟, 王瑞枝. 手术室护理干预对预防胃肠道手术切口感染的临床效果探讨[J]. 现代消化及介入诊疗, 2022,1(2):1652-1652.

[3]黄蓓蓓, 袁萍. 手术室护理干预预防胃肠道手术切口感染的效果研究[J]. 重庆医学, 2022, 51(1):462-463.

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[5]卢效娟, 卢娜利. 手术室护理干预对胃肠道手术患者切口感染的预防效果分析[J]. 山西医药杂志, 2021, 50(9):1577-1579.