三种不同时机下术前导尿配合手术室护理对全麻手术患者苏醒期躁动的影响

摘要 目的 观察三种不同时机下术前导尿配合手术室护理对全身麻醉（全麻）手术患者苏醒期躁动的影响。方法 选择2017年1月～2018年12月于我院行择期全麻手术的患者100例，根据术前导尿时机分为3组：A组（手术当日清晨在病房导尿，33例）、B组（麻醉前在手术室导尿，30例）、C组（麻醉平稳后在手术室导尿，37例）。记录并比较3组麻醉时间、术中输液量、术中出血量、苏醒时间及导尿前后收缩压（SBP）、舒张压（DBP）及心率（HR）变化，比较3组一次性导尿成功率、术后导尿管适应度及苏醒期躁动发生情况，采用自拟问卷调查患者护理满意度。结果 3组麻醉时间、术中输液量、术中出血量及苏醒时间比较，差异无统计学意义（P>0.05）；A组导尿后SBP、DBP、HR较导尿前均显著升高（P<0.05），B组和C组SBP、DBP、HR与导尿前比较，差异无统计学意义（P>0.05）；A组一次性导尿成功率显著低于B组和C组，术后导尿管适应度显著差于B组和C组（P<0.05）；A组苏醒期躁动发生率显著高于C组，苏醒期躁动分级显著高于C组P<0.05）；A组护理满意度评分显著低于B组和C组，差异有统计学意义（P<0.05）。结论 在麻醉前后于手术室进行导尿的效果明显优于手术当日清晨在病房导尿，配合手术室护理干预可有效提高患者术后对导尿管的适应度，降低苏醒期躁动发生率，提高患者护理满意度。

Effects of preoperative catheterization on patients with emergence agitation after general anesthesia on three different occasions

Abstract Objective To observe the effects of preoperative catheterization under three different timings combined with operating room nursing on emergence agitation of patients with general anesthesia surgery. Methods A total of 100 patients undergoing elective general anesthesia in our hospital from January 2017 to December 2018 were selected. According to the timings of preoperative catheterization, they were divided into three groups, including group A (catheterization in the ward on the morning of surgery, 33 cases), group B (catheterization in the operating room before anesthesia, 30 cases) and group C (catheterization in the operating room after stable anesthesia, 37 cases). The changes of anesthesia time, intraoperative fluid volume, intraoperative blood loss, recovery time and systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) before and after catheterization were recorded and compared among the three groups. The success rate of one-time catheterization, postoperative catheter adaptability and occurrence of emergence agitation were compared among the three groups, and self-made questionnaire was used to investigate the patient nursing satisfaction. Results There were no significant differences in the anesthesia time, intraoperative fluid volume, intraoperative blood loss and recovery time among the three groups (P>0.05). The SBP, DBP and HR in group A after catheterization were significantly higher than those before catheterization (P<0.05), and there were no significant differences in the SBP, DBP and HR in group B and group C compared with those before catheterization (P>0.05). The success rate of one-time catheterization in group A was significantly lower than that in group B and group C, and the postoperative catheter adaptability was significantly worse than that in group B and group C (P<0.05). The incidence rate of emergence agitation in group A was significantly higher than that in group C while the emergence agitation grading was significantly higher than that in group C (P<0.05). The nursing satisfaction score in group A was significantly lower than that in group B and group C (P<0.05). Conclusion The effect of catheterization in the operating room before and after anesthesia is significantly better than that in the ward on the morning of surgery. Combined operating room intervention can effectively improve the postoperative catheter adaptability, reduce the incidence rate of emergence agitation, and enhance patient nursing satisfaction.