摘要
目的:探讨基于前馈控制理念的风险预警干预护理在降低卵巢囊肿(OC)患者术中风险事件发生率及应激反应的可行性。方法:收集2022年1月-2024年8月本院确诊且接受择期行腹腔镜卵巢囊肿剥除术治疗的OC患者190例,将2022年1月-2023年1月入院的OC患者纳入对照组(n=95例),将2023年2月-2024年8月入院的OC患者纳入观察组(n=95例)。对照组接受常规护理干预,观察组接受基于前馈控制理念的风险预警手术室护理,两组护理均持续2周。记录两组患者术后意识恢复时间、肠功能恢复时间、拔管时间、首次下床活动时间、不同时间点[手术室后10min或麻醉诱导前(T1)、气腹后10 min(T2)、解除气腹后5 min(T3)、手术结束(T4)]患者的鼻咽温度、术后意识恢复后寒战、围术期风险事件(低体温、寒战、低血压、感染、深静脉血栓等)、不同时间点应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(AD)]、护理满意度。结果:观察组术后意识恢复时间、肠功能恢复时间、进食时间、拔管时间、首次下床活动时间均少于对照组(P<0.05)。两组不同时间点、组间鼻咽温度、Cor、NE、AD主效应,交互作用均有差异且T2~T4观察组鼻咽温度、Cor、NE、AD较对照组更低(P<0.05)。观察组意识恢复后寒战发生、围术期风险事件(16.8%)发生均低于对照组(35.7%),总满意度(84.2%)高于对照组(93.7%)(均P<0.05)。结论:基于前馈控制理念的风险预警干预护理可用于卵巢囊肿手术,在降低术中风险事件发生率及应激反应有一定优势。
Objective:To investigate the feasibility of the risk early warning intervention nursing based on the feedback control concept for reducing the incidence of the intraoperative risk events and stress responses of patients with ovarian cysts(OC)surgery.Methods:A total of 190 patients with OC who treated with elective laparoscopic ovarian cystectomy in the hospital were collected in this study from January 2022 to August 2024,including 95 patients admitted from January 2022 to January 2023 were included in control group and 95 patients admitted from February 2023 to August 2024 were included in observation group.The patients in the control group received the routine nursing intervention for 2 weeks,while the patients in the observation group received the risk early warning operating room nursing based on the feedback control concept for 2 weeks.The time of postoperative recovery consciousness,the time of intestinal function recovery,the extubation time,the time of the first getting out of bed,the nasopharyngeal temperature at different time points,such as at 10 minutes after entering the operating room or before anesthesia induction(T1),at 10 minutes after pneumoperitoneum(T2),at 5 minutes after relieving pneumoperitoneum(T3)and at the end of surgery(T4),the rate of shivering after the postoperative recovery of consciousness,the perioperative risk events,such as hypothermia,shivering,hypotension,infection and deep vein thrombosis,the levels of the stress response indicators at different time points,such as cortisol(Cor),noradrenaline(NE)and adrenaline(AD,and the nursing satisfaction of the patients in the two groups were recorded.Results:The postoperative consciousness recovery time,the intestinal function recovery time,the feeding time,the extubation time and the time of the first getting out of bed of the patients in the observation group were significantly less than those of the patients in the control group(P<0.05).The nasopharyngeal temperature and the levels of Cor,NE and AD of the patients at different time points were significantly different between the two groups,and which of the patients in the observation group at T2-T4 were significantly lower than those of the patients in the control group(P<0.05).The incidence of shivering after the consciousness recovery of the patients in the observation group was significantly lower than that of the patients in the control group.The perioperative risk events incidence(16.8%)of the patients in the observation group was significantly lower than that(35.7%)of the patients in the control group.The total satisfaction(84.2%)of the patients in the observation group was significantly higher than that(93.7%)of the patients in the control group(all P<0.05).Conclusion:The risk early warning intervention nursing based on the feedback control concept for the patients with ovarian cyst surgery has certain advantages in reducing their intraoperative risk events and stress responses.
作者
祁纯
程思怡
张蕤
QI Chun;CHENG Siyi;ZHANG Rui(Wuhan First Hospital,Wuhan,Hubei Province,430022)
出处
《中国计划生育学杂志》
2025年第6期1336-1341,共6页
Chinese Journal of Family Planning
关键词
卵巢囊肿腹腔镜手术
前馈控制理念
风险预警
应激反应
术后恢复
风险事件
满意度
Laparoscopic surgery of ovarian cysts
Feedback control concept
Risk early warning
Stress response
Postoperative recovery
Risk event
Satisfaction
