目的 探讨基于症状管理理论的冰水喷雾对胸腔镜下肺叶切除术口渴患者的应用效果。方法 便利抽样法选取2023年11月—2024年4月在某医院行胸腔镜下肺叶切除术的患者84例为研究对象。根据患者手术时间先后分为为42例观察组,42例对照组。对照组给予常规护理,试验组在常规护理基础上实施基于症状管理理论的冰水喷雾干预。记录2组患者口渴程度、口腔黏膜湿润度、静息唾液流率、围术期口渴不适评分、反流、误吸、呕吐及呛咳的发生情况比较。结果 干预后观察组口渴程度、围术期口渴不适评分均明显低于对照组（P<0.001）,静息唾液流率、口腔黏膜湿润度明显高于对照组（P<0.001）,2组患者均无反流、误吸、呛咳情况发生,观察组有1例、对照组有2例患者出现呕吐,差异无统计学意义（P>0.05）。结论 基于症状管理理论的冰水喷雾可缓解胸腔镜下肺叶切除患者口渴程度,提高患者术后口腔舒适度且安全可行。
Abstract
Objective To explore the application effect of ice water spray based on symptom management theory (SMT) in thirsty patients undergoing thoracoscopic lobectomy. Methods Convenience sampling was used to select patients who underwent thoracoscopic lobectomy from November 2023 to April 2024 as research subjects. According to the operation time, the patients were divided into observation group and control group, with 42 cases in each. The control group was given routine nursing, and the observation group was given SMT-based ice water spray intervention on the basis of routine nursing. The degree of thirst, oral mucosal moisture, resting salivary flow rate, perioperative thirst discomfort score, reflux, aspiration, vomiting and cough were recorded and compared between the two groups. Results After intervention, the degree of thirst in the observation group was notably alleviated (P<0.001). Perioperative thirst discomfort score in the observation group was markedly lower than that in the control group (P<0.001). Resting salivary flow rate in the observation group was greatly higher than that in the control group (P<0.001). Oral mucosal wettability in the observation group was notably higher than that in the control group (P<0.001). There was no significant difference in reflux, aspiration, cough and vomiting between the two groups (P>0.05). Conclusion Ice water spray based on SMT can alleviate the degree of thirst in patients undergoing thoracoscopic lobectomy and improve patient comfort and it is safe and feasible.
关键词
症状管理理论 /
冰水喷雾 /
围术期口渴 /
肺叶切除术
Key words
symptom management theory /
ice water spray /
perioperative thirst /
lobectomy
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Feray S, Lubach J, Joshi GP, et al.Prospect guidelines for video-assisted thoracoscopic surgery: a systematic review and procedure-specific postoperative pain management recommendations[J]. Anaesthesia, 2022, 77(3): 311-325. DOI:10.1111/anae.15609.
[2] 云麟钧, 潘燕, 刘嘉欣, 等. 胸腔镜下肺叶切除术后患者麻醉复苏早期饮水的安全性[J]. 护理学杂志, 2020, 35(24): 55-57. DOI: 10.3870/j.issn.1001-4152.2020.24.055.
[3] 唐鑫烨, 徐虹霞, 徐亦虹, 等. 腹腔镜下肝胆手术患者全麻苏醒后早期饮水时机的研究[J]. 护理学报, 2023, 30(24): 53-56. DOI: 10.16460/j.issn1008-9969.2023.24.053.
[4] Linder L.Analysis of the UCSF Symptom Management Theory: implications for pediatric oncology nursing[J]. J Pediatr Oncol Nurs,2010,27(6):316-324.DOI:10.1177/1043454210368532.
[5] 褚红,陈雁,韩世钰,等. 基于症状管理理论的多发性骨髓瘤患者干预方案的构建与应用[J].护理学报,2024,31(21):68-73. DOI:10.16460/j.issn1008-9969.2024.21.068.
[6] 涂文怡, 尹志勤, 叶丹, 等. 急性A型主动脉夹层患者术后气管插管期间口渴管理的研究[J]. 护士进修杂志, 2020, 35(9): 824-827. DOI: 10.16821/j.cnki.hsjx.2020.09.013.
[7] Motta n H, Do nascimentol A, Pierotti I, et al. Evaluation of a Safety Protocol for the Management of Thirst in the Postoperative Period[J]. J Perianesth Nurs, 2020, 35(2): 193-197. DOI:10.1016/j.jopan.2019.07.005.
[8] Sessler c N, Gosnell MS, Grap MJ, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients[J]. Am J Respir Crit Care Med, 2002, 166(10): 1338-1344. DOI:10.1164/rccm.2107138.
[9] 张小雪, 何朝珠, 涂惠, 等. 冰水喷雾对经口气管插管病人口渴程度的影响[J]. 护理研究, 2021, 35(2): 325-328. DOI: 10.12102/j.issn.1009-6493.2021.02.026.
[10] 王正国创伤医学基金会围术期加速康复护理联盟. 成人术后口渴症状评估与管理的专家共识[J].军事护理, 2022, 39(12): 1-4. DOI: 10.3969/j.issn.2097-1826.2022.12.001.
[11] Arai S, Stotts N, Puntillo K.Thirst in critically ill patients: from physiology to sensation[J]. Am J Crit Care, 2013, 22(4): 328-335. DOI:10.4037/ajcc2013533.
[12] 张英, 崔丹. 口干症的临床评估及对策[J]. 中国实用口腔科杂志, 2017, 10(9):530-534. DOI: 10.19538/j.kq.2017.09.005.
[13] 刘云访, 兰星, 孙翠翠, 等. 围手术期口渴不适量表的汉化及其在麻醉复苏室患者中的信效度检验[J]. 现代临床护理, 2023, 22(9): 66-71. DOI: 10.3969/j.issn.1671-8283.2023.09.010.
[14] Martinsp R, Fonseca lF, Rossettoe G. Developing and validating the Perioperative Thirst Discomfort Scale[J]. Rev Esc Enferm USP, 2017, 51(e03240. DOI: 10.1590/S1980-220X2016029003240.
[15] Walker e m K, Bell M, Cook TM, et al. Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study[J]. Br J Anaesth, 2016, 117(6):758-766. DOI:10.1093/bja/aew381.
[16] Lee CW, Liu ST, Cheng YJ, et al.Prevalence, risk factors, and optimized management of moderate-to-severe thirst in the post-anesthesia care unit[J]. Sci Rep, 2020, 10(1): 16183. DOI:10.1038/s41598-020-73235-5.
[17] 章志伟, 祖娟, 徐英, 等. 麻醉恢复期患者不悦症状体验的质性研究[J]. 军事护理, 2022, 39(10): 65-68. DOI: 10.3969/j.issn.2097-1826.2022.10.017.
[18] 郭晓强, 马克世. 冷受体TRPM8在冷感知中的作用和调节[J]. 生命的化学, 2008, 28(4): 388-390. DOI: 10.3969/j.issn.1000-1336.2008.04.004.
[19] 魏越, 陆希, 张静, 等. 术前2h口服碳水化合物对妇科腹腔镜特殊体位手术患者胃容量及反流误吸风险的影响[J]. 北京大学学报(医学版), 2023, 55(5):893-398. DOI: 10.19723/j.issn.1671-167X.2023.05.018
[20] 刘翠, 唐建华, 汤木翠, 等. 3例食管癌并发气管食管瘘及气管憩室患者的护理[J]. 护理学报, 2022, 29(2): 68-70. DOI: 10.16460/j.issn1008-9969.2022.02.068.
PDF(701 KB)
