韦佳萍　韦云萍　何静　韦靖

摘要：目的  探討系统性呼吸道护理干预在心脏瓣膜病患者围手术期的应用效果。方法  采用便利法抽取2016年10月～2017年9月我院接受心脏瓣膜置换术的61例患者设为对照组，另选取2017年10月～2018年12月我院接受心脏瓣膜置换术的56例患者设为干预组，对照组给予常规护理干预，干预组在对照组基础上予以系统性呼吸道护理干预，比较两组术后ICU时间、住院时间、术后肺部并发症发生情况及自主排痰掌握率。结果  两组术后ICU时间比较[（42.28±4.24）h vs（43.50±3.17）h]，差异无统计学意义（P>0.05）;干预组住院时间短于对照组[（18.44±2.31）d vs（19.42±2.44）d]，差异有统计学意义（P<0.05）。干预组术后肺部并发症发生率低于对照组（8.93% vs 24.59%），自主排痰掌握率高于对照组（53.57% vs 29.51%），差异有统计学意义（P<0.05）。结论  系统性呼吸道护理干预能有效缩短患者住院时间、减少术后肺部并发症的发生，提高患者自主排痰掌握率。

关键词：心脏瓣膜置换;系统性呼吸道护理干预;肺部并发症

中图分类号：R473                                  文献标识码：A                                  DOI：10.3969/j.issn.1006-1959.2020.14.060

文章编号：1006-1959（2020）14-0180-03

Effect of Systematic Respiratory Nursing Intervention on Prevention of Pulmonary Complications

After Heart Valve Replacement

WEI Jia-ping，WEI Yun-ping，HE Jing，WEI Jing

（Cardiovascular and Thoracic Surgery，People's Hospital of Guangxi Zhuang Autonomous Region，Nanning 530021，Guangxi，China）

Abstract：Objective  To explore the effect of systemic respiratory tract nursing intervention on patients with heart valve disease during perioperative period.Methods  Using convenience method， 61 patients who underwent heart valve replacement in our hospital from October 2016 to September 2017 were selected as the control group， and 56 patients who underwent heart valve replacement in our hospital from October 2017 to December 2018 were selected. The patients were set as the intervention group， the control group was given routine nursing intervention， and the intervention group was given systematic respiratory nursing intervention based on the control group， comparing the postoperative ICU time， hospital stay， postoperative pulmonary complications and voluntary discharge sputum control rate.Results  The postoperative ICU time of the intervention group was （42.28±4.24）h， compared with the control group's （43.50±3.17）h， the difference was not statistically significant （P>0.05）; the hospitalization time of the intervention group was shorter than that of the control group [（18.44±2.31） d vs （19.42±2.44） d]， the incidence of postoperative pulmonary complications is lower than the control group （8.93% vs 24.59%）， and the rate of autonomous sputum control is higher than the control group （53.57% vs 29.51%），the difference was statistically significant （P<0.05）.Conclusion  Systematic respiratory tract nursing intervention can effectively shorten the hospitalization time of patients， reduce the occurrence of postoperative pulmonary complications， and improve the patient's autonomous sputum control rate.

Key words：Heart valve replacement;Systemic respiratory care intervention;Pulmonary complications

心脏瓣膜病（heart valve disease，HVD）是心脏外科最常见疾病之一[1]，我国每年需要瓣膜手术的患者约20万例[2]，主要包括风湿性心脏瓣膜病和瓣膜退行性病变患者。风湿性心脏瓣膜病占心脏外科手术患者的40%～50%[3]，随着社会人口老龄化，瓣膜退行性变的患者在逐渐增加，需要外科治疗的患者也在逐渐增多，其治疗手段大多需要瓣膜置换手术治疗。心脏外科技术水平的逐日完善，心脏瓣膜置换术术后并发症发生率也有所降低，但术后肺部并发症仍然是心脏瓣膜置换术围手术期最常见的问题之一[4]，不但增加患者住院时间及住院费用，影响患者术后恢复，而且影响患者的生命安全。据报道[5]，心脏瓣膜置换术后，肺部并发症比例高达13%～ 25%，在心脏瓣膜置换术后死亡病例中，因肺部并发症死亡者占1/3。因此……