吴 蕾

全面护理干预老年患者腹部手术后肺部感染发生率的影响

吴 蕾

目的 分析全面护理干预对老年患者腹部手术后肺部感染发生率的影响。方法 选取2013年5月～2015年1月我院老年腹部手术患者110例为研究对象，采用随机数表法分为观察组和对照组各55例，对照组给予常规护理干预，观察组在此基础上实施全面护理干预，均干预2个月，比较两组术后第1、2、3、4 d排痰量，采用本院自拟腹部手术患者护理满意度评分表评价其护理满意度，并比较两组住院时间及肺部感染率。结果 术后第1、2、3、4 d观察组排痰量与对照组比较较高（P＜0.05）；观察组住院时间（10.17±1.26）d较对照组缩短（P＜0.05），观察组肺部感染率7.27%低于对照组21.82%（P＜0.05）；观察组护理满意度92.73%高于对照组76.36%（P＜0.05）。结论 全面护理干预可增加老年患者腹部手术后排痰量，缩短住院时间，降低肺部感染率。

全面护理干预；老年；腹部手术；肺部感染；发生率

【Abstract】

Objective To analyze the effects of comprehensive nursing intervention on the incidence of pulmonary infection after abdominal operation in elderly patients. Methods 110 elderly patients who received abdominal operation in our hospital from May 2013 to January 2015 were selected as the research objects. They were divided by random number table into the observation group and the control group（each 55 cases）. The control group received routine nursing intervention for 2 months，the observation group received comprehensive nursing intervention on the basis of the above for 2 months，sputum volume at 1，2，3，4 d after the operation in the two groups were compared，abdominal operation patients nursing satisfaction rating scaledesigned by our hospital was used to estimate nursing satisfaction，hospitalization time and the incidence of pulmonary infection in the two groups were compared. Results Sputum volume at 1，2，3，4 d after the operation in the observation group were significantly higher than the control group（P＜ 0.05）. Hospitalization time（10.17±1.26）d was significantly shorter than the control group（P＜ 0.05）. Incidence of pulmonary infection in the observation group 7.27%，was significantly lower than the control group（21.82%）（P＜0.05）； nursing satisfaction in the observation group 92.73% was significantly higher than the control group（76.36%）（P＜0.05）. Conclusion Comprehensive nursing intervention can significantly increase postoperative sputum volume in elderly abdominal operation patients，shorten hospitalization time，reduce incidence of pulmonary infection.

【Key words】Comprehensive nursing intervention，Elderly，Abdominal operation，Pulmonary infection，Incidence

近年来随我国人口老龄化加速，外科老龄患者比例逐渐升高，尤其是70岁以上老年人群，因免疫功能低下、器官功能减退表现为生理功能储备不足、应急能力下降，因此老年患者围术期的护理是每个外科医师必须思考的问题［1-3］。老年患者进行较多的手术是腹部手术，目前临床腹部大型手术常需进行全身麻醉及机械通气，但全身麻醉时机械通气可造成肺功能损伤，形成肺部感染等并发症，感染后可引发机体多脏器功能损伤，已成为腹部手术术后死亡的主要原因，研究显示既往慢性肺疾病、糖尿病史、手术时间延长、白蛋白水平低下等是老年患者全身麻醉腹部手术后肺部感染的独立因素，因此对行腹部手术的老年患者实施术前术后全面护理对促进患者康复及术后生活质量提高有重要意义［4-5］。……