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多维危机控制理念在老年喉癌患者切除术后气道管理中的应用

Application of multi-dimensional crisis control concept in airway management of elderly patients after resection surgery for laryngeal cancer

    摘要
  • 摘要:
    目的 观察多维危机控制理念在老年喉癌切除术患者术后气道管理中的应用效果。
    方法 将208例行喉癌切除术伴气管切开的老年喉癌患者随机分为干预组（n=104）和对照组（n=104）。对照组给予常规护理，干预组在对照组基础上给予多维危机控制理念护理。比较2组患者气道湿化效果、并发症和气管套管意外脱管事件发生情况、心理状态、舒适度。
    结果 干预组气道湿化满意率为96.15%，高于对照组的81.73%，差异有统计学意义（P＜0.05）。干预组并发症发生率为11.54%，低于对照组的24.04%，差异有统计学意义（P＜0.05）。干预组意外脱管总发生率为0.96%，低于对照组的6.73%，差异有统计学意义（P＜0.05）。干预3个月后，2组患者焦虑自评量表（SAS）、抑郁自评量表（SDS）评分均较干预前下降，且干预组SAS、SDS评分低于对照组，差异均有统计学意义（P＜0.05）。干预后，干预组的舒适度各项评分及总分均高于对照组，差异有统计学意义（P＜0.05）。
    结论 在老年喉癌术后患者的气道管理中，采取多维危机控制理念的护理干预有助于降低并发症及气管导管意外脱管的发生率，提升气道湿化效果，还可有效缓解患者的心理压力，提高患者舒适度。

     

    Abstract:
    Objective To observe the application effect of multi-dimensional crisis control concept in postoperative airway management of elderly patients with resection surgery for laryngeal cancer.
    Methods A total of 208 elderly patients with resection surgery for laryngeal cancer and tracheotomy were randomly divided into intervention group (n=104) and control group (n=104). The control group was given routine nursing, while the intervention group was given multi-dimensional crisis control concept nursing on the basis of the control group. The airway humidification effect, occurrence of complications and accidental tracheal tube extubation, psychological status and comfort degree werecompared between the two groups.
    Results The satisfaction degree of airway humidification in the intervention group was 96.15%, which was significantly higher than 81.73% in the control group (P < 0.05). The incidence of complications in the intervention group was 11.54%, which was significantly lower than 24.04% in the control group (P < 0.05). The total incidence of accidental extubation in the intervention group was 0.96%, which was significantly lower than 6.73% in the control group (P < 0.05). After 3 months of intervention, the scores of the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) in both groups decreased significantly when compared to those before intervention, and the scores of SAS and SDS in the intervention group were significantly lower than those in the control group (P < 0.05). After intervention, the scores of items of comfort degree and the total score in the intervention group were significantly higher than those in the control group (P < 0.05).
    Conclusion In the airway management of elderly patients after laryngeal cancer surgery, application of multi-dimensional crisis control concept nursing intervention can reduce the incidence of complications and accidental tracheal tube extubation, improve airway humidification effect, effectively alleviate psychological pressure of patients, and improve patient's comfort degree.

     

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