精准护理措施在临床留置胃管中的应用效果观察(1)
摘 要：目的 探讨临床留置胃管应用精准护理干预的效果。方法 选取2017年1月～3月收治于同济大学附属杨浦医院进行留置胃管的患者107例为观察组，2016年10月～12月在我院进行留置胃管治疗的患者101例为对照组，将两组留置胃管的临床置管期间导管安全、护理质量、意外拔管发生率、护理满意度进行对比分析。结果 护理干预后，观察组护理质量检查规范率为88.12%，高于对照组的14.95%；观察组意外拔管率为0.99%，低于对照组的6.54%；观察组护理满意度为99.01%，高于对照组的83.18%，组间对比，差异具有统计学意义(P<0.05)。结论 临床留置胃管患者落实精准化护理措施干预效果显著，可保障留置胃管期间的管路安全，提高患者置管期间的舒适度，降低意外拔管发生率，提高护理满意度。
关键词：留置胃管；意外拔管率；精准护理；导管工作坊；护理干预
中图分类号：R473.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.12.056
, 百拇医药
文章编号：1006-1959(2018)12-0173-03
Abstract：Objective To investigate the effect of precious nursing intervention on clinical indwelling gastric tube.Methods 127 patients admitted to Yangpu Hospital Affiliated to Tongji University from January 2017 to March 2017 were selected as the observation group.101 patients were treated with indwelling gastric tube in our hospital from October to December 2016 as control group.Contrast analysis of catheter safety，quality of care，incidence of accidental extubation，and satisfaction of care during clinical placement of the two groups of indwelling gastric tubes.Results After the nursing intervention，the standard rate of examination for nursing quality in the observation group was 88.12%，which was higher than 14.95% of the control group.The rate of accidental extubation in the observation group was 0.99%，which was lower than that of the control group 6.54%；the satisfaction rate of the observation group was 99.01%，it was higher than that of the control group 83.18%，and the difference between the two groups was statistically significant(P<0.05).Conclusion The effect of precious nursing intervention on gastric tube patients with clinical retention is significant，which can guarantee the safety of the pipeline during the retention of gastric tube，improve the comfort of the patients during the tube placement，reduce the incidence of accidental extubation and improve the satisfaction of nursing.
, 百拇医药
Key words：Indwelling gastric tube；Accidental extubation rate；Precious nursing；Catheter workshop；Nursing intervention
胃管留置是臨床常用的护理技术之一，主要的作用是通过胃管引流出胃肠道内的积液积气，降低胃肠道内的压力和张力，改善胃肠壁的血液循环，促进胃肠功能恢复的一种有效的治疗措施；同时还能通过胃管注入食物、药物，以达到补充营养，维持生命的作用。留置胃管护理在临床主要包括胃管位置、确认胃管位置、鼻饲喂养、鼻饲给药、鼻饲并发症的预防及管理问题[1]。美国医学界在2011年首次提出了“精准医学”[2](Precious Medicine)概念，2015年1月20日奥巴马又在美国国情咨文中提出并启动了“精准医学计划”，为适应精准医疗的不断发展，精准护理也将成为今后护理实践的重要原则。随着社会老年化发展趋势，现在临床依靠胃管留置进行治疗及护理的比例大大提高，如何应用依托“精准医学”衍生的精准护理概念，进行相应护理措施干预[3，4]。本研究对提高留置胃管的置管时间，保障置管期间的患者安全，预防意外拔管发生率进行探讨，现报道如下。
1资料与方法
1.1一般资料 选取2017年1月～3月收治于同济大学附属杨浦医院进行留置胃管的患者107例为观察组，2016年10月～12月在上海市杨浦区中心医院进行留置胃管治疗的患者101例为对照组。纳入标准：①选择全院内科、外科共12个病区需要进行留置胃管治疗的患者；②留置胃管≥1 d；③患者无意识障碍或精神异常；④发生意外拔管纳入护理质量考核；⑤患者签署知情同意书。排除标准：中途中断或退出研究者。观察组男43例，女57例，年龄63～82岁，平均年龄(75.21±12.12)岁；对照组男52例，女48例，年龄61～81岁，平均年龄(71.52±9.80)岁。两组患者一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(沈伟娟 刘艳明 仇建华 姚韻 姚蔚兰)
关键词：留置胃管；意外拔管率；精准护理；导管工作坊；护理干预
中图分类号：R473.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.12.056
, 百拇医药
文章编号：1006-1959(2018)12-0173-03
Abstract：Objective To investigate the effect of precious nursing intervention on clinical indwelling gastric tube.Methods 127 patients admitted to Yangpu Hospital Affiliated to Tongji University from January 2017 to March 2017 were selected as the observation group.101 patients were treated with indwelling gastric tube in our hospital from October to December 2016 as control group.Contrast analysis of catheter safety，quality of care，incidence of accidental extubation，and satisfaction of care during clinical placement of the two groups of indwelling gastric tubes.Results After the nursing intervention，the standard rate of examination for nursing quality in the observation group was 88.12%，which was higher than 14.95% of the control group.The rate of accidental extubation in the observation group was 0.99%，which was lower than that of the control group 6.54%；the satisfaction rate of the observation group was 99.01%，it was higher than that of the control group 83.18%，and the difference between the two groups was statistically significant(P<0.05).Conclusion The effect of precious nursing intervention on gastric tube patients with clinical retention is significant，which can guarantee the safety of the pipeline during the retention of gastric tube，improve the comfort of the patients during the tube placement，reduce the incidence of accidental extubation and improve the satisfaction of nursing.
, 百拇医药
Key words：Indwelling gastric tube；Accidental extubation rate；Precious nursing；Catheter workshop；Nursing intervention
胃管留置是臨床常用的护理技术之一，主要的作用是通过胃管引流出胃肠道内的积液积气，降低胃肠道内的压力和张力，改善胃肠壁的血液循环，促进胃肠功能恢复的一种有效的治疗措施；同时还能通过胃管注入食物、药物，以达到补充营养，维持生命的作用。留置胃管护理在临床主要包括胃管位置、确认胃管位置、鼻饲喂养、鼻饲给药、鼻饲并发症的预防及管理问题[1]。美国医学界在2011年首次提出了“精准医学”[2](Precious Medicine)概念，2015年1月20日奥巴马又在美国国情咨文中提出并启动了“精准医学计划”，为适应精准医疗的不断发展，精准护理也将成为今后护理实践的重要原则。随着社会老年化发展趋势，现在临床依靠胃管留置进行治疗及护理的比例大大提高，如何应用依托“精准医学”衍生的精准护理概念，进行相应护理措施干预[3，4]。本研究对提高留置胃管的置管时间，保障置管期间的患者安全，预防意外拔管发生率进行探讨，现报道如下。
1资料与方法
1.1一般资料 选取2017年1月～3月收治于同济大学附属杨浦医院进行留置胃管的患者107例为观察组，2016年10月～12月在上海市杨浦区中心医院进行留置胃管治疗的患者101例为对照组。纳入标准：①选择全院内科、外科共12个病区需要进行留置胃管治疗的患者；②留置胃管≥1 d；③患者无意识障碍或精神异常；④发生意外拔管纳入护理质量考核；⑤患者签署知情同意书。排除标准：中途中断或退出研究者。观察组男43例，女57例，年龄63～82岁，平均年龄(75.21±12.12)岁；对照组男52例，女48例，年龄61～81岁，平均年龄(71.52±9.80)岁。两组患者一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(沈伟娟 刘艳明 仇建华 姚韻 姚蔚兰)