静脉麻醉超声支气管镜引导下经支气管针吸活检术的精准护理.docx

【摘要】 目的：总结静脉麻醉超声支气管镜引导下经支气管针吸活检（EBUS-TBNA）术患者的精准护理。方法：回顾性分析2013年4月-2016年1月532例行静脉麻醉下EBUS-TBNA检查患者的临床资料，其中5例患者采用喉罩辅助呼吸下完成操作，其余患者均为面罩通气自主呼吸。其中331例（精准护理组）为术前充分评估患者病情，制定精准护理方案，并对患者行个体化宣传教育，术中快速准确医护配合，术后细致观察，精准护理。余201例（对照组）仅实施基础常规护理，未予精准护理病例。比较两组患者的效果。结果：532例患者均顺利完成检查，无围手术期死亡病例，与对照组比较，精准护理组平均手术时间短、淋巴结穿刺取材满意率高、术后并发症少，患者满意度高，差异均有统计学意义（P0.05）。结论：精准的护理配合，能提高静脉麻醉下EBUS-TBNA术穿刺成功率，缩短手术时间，降低术后并发症。 　　【关键词】 超声支气管镜经支气管针吸活检； 精准护理 　　【Abstract】 Objective：To conclude the precise nursing experiences of endobronchial ultrasound-guided transbronchial needle aspiration under intravenous anesthesia.Method：The clinical data of 532 patients underwent the endobronchial ultrasound-guided transbronchial needle aspiration of intravenous anesthesia from April 2013 to January 2016 were retrospectively analyzed，5 patients completed the process by laryngeal mask assisted respiration，the rest of patients were by mask ventilation autonomous respiration.532 patients，331 patients（the precise nursing group） were provided fully evaluation before operation，then the precise nursing care plans were settled，and individual education for each patient were taked and through the accurate cooperation between doctor and nurse during the operation，plus careful observation and accurate nursing care post operation.Another 201 patients（the control group） didn’t accept precise nursing.The effects of two groups were compared.Result：All patients underwent successful examination，no perioperative deaths.Compared with the control group，the precise nursing group costed less average surgery time，had less post-operation complications，and got higher satisfaction rate，patient atisfaction，the differences of two group were significant（P0.05）.Conclusion：Precise nursing cooperation can improve the success puncture rate of intravenous anesthesia EBUS-TBNA，shorten operation time，reduce postoperative complications. 　　【Key words】 Endobronchial ultrasound-guided transbronchial needle aspiration； Nursing 　　First-author’s address：The Thi