徐雪峰河南省镇平县中医院重症监护室，河南南阳　474250

综合护理管理在胸外科重症术后呼吸功能恢复的效果观察

徐雪峰
河南省镇平县中医院重症监护室，河南南阳474250

目的探讨影响胸外科重症患者术后呼吸功能恢复的各种因素，对综合护理管理效果进行评价。方法将76例胸外科重症接受开胸手术患者随机分为对照组和观察组，每组38例；对照组患者行胸外科重症手术围手术期常规护理管理手段，观察组患者在常规护理管理的基础上增加综合护理管理措施；观察两组患者的呼吸功能恢复情况，统计分析采用SPSS19.0进行。结果两组患者呼吸功能均得到有效恢复，无死亡病例。观察组患者肺功能指标以及血气动力学指标变化改善程度均显著优于对照组（P＜0.01）。观察组患者的SGRQ总分及SF-36总分改善程度显著优于对照组（P＜0.01）。结论综合护理管理模式对胸外科重症术后呼吸功能恢复具有良好的效果，确保手术治愈率，提高患者生存质量。

综合护理管理；重症患者；开胸手术；呼吸功能；效果观察

［Abstract］Objective To study the various factors which have an effect on the respiratory function recovery after the severe operation of thoracic surgery and evaluate the comprehensive nursing management effect.Methods 76 cases of patients with severe disease of thoracic surgery and receiving thoracotomy were randomly divided into two groups with 38 cases in each，the control group adopted conventional nursing management means in the perioperative period，the observation group adopted comprehensive nursing management measures on the basis of the conventional nursing management，and the respiratory function recovery of the two groups was observed，counted and analyzed by the SPSS19.0.Results The respiratory function obtained effective recovery without death case，the improvement degrees of lung function index and blood gas dynamics index in the observation group were obviously better than those in the control group（P＜0.01），the improvement degrees of SGRQ total score and SF-36 total scores in the observation group were obviously better than those in the control group（P＜0.01）.Conclusion The effect of comprehensive nursing management model for respiratory function recovery after the severe operation of thoracic surgery is good，which can ensure the operation cure rate and improve the survival quality of patients.

［Key words］Comprehensive nursing management；Severe patients；Thoracotomy；Respiratory function；Effect observation

胸外科重症主要指发生于胸腔内的脏器如食道、肺部、纵膈、乳腺等部位的重大病变。此类病变一旦确定手术治疗，必然需要进行开胸手术，而开胸手术造成的不可避免的肺泡萎陷、肺循环阻力骤增、肺通气量锐减等现象，均会导致机体呼吸、循环系统的严重损伤［1］。因此，术后患者的呼吸功能恢复往往会比较困难，且容易出现各种呼吸系统并发症，严重者甚至危及生命［2］。……