标准化情景演练模式在PCNL术后尿源性脓毒血症患者救治中的应用价值

目的尿源性脓毒血症是泌尿系结石尤其是感染性肾结石患者经皮肾镜碎石取石术（PCNL）术后最凶险的并发症之一。本研究拟通过临床效果评价，探讨标准化情景演练模式在PCNL术后尿源性脓毒血症患者救治中的应用价值。 方法收集2019年1月至2020年12月在我院泌尿外科行PCNL术后发生尿源性脓毒血症患者的处置记录和临床资料，其中2019年度患者为采用标准化情景演练模式前组，2020年度患者为采用标准化情景演练模式后组。分别对护士的预判成功率，抢救物品准备时间，对患者采取有效措施时间，患者救治成功率以及患者术后住院天数进行统计学分析。 结果采用标准化情景演练模式前后，护士对PCNL术后尿源性脓毒血症的预判成功率分别为：12.5%（1/8）vs 80.0%（8/10），（P<0.05）；平均用物准备时间分别为：（6.6±0.7）min vs （3.4±0.5）min，（P<0.05）；对患者采取有效措施时间分别为：（10.8±2.0） min vs（5.0±1.6）min，（P<0.05）；患者救治成功率分别为：75.0%（6/8）vs 90.0%（9/10） （P>0.05）；患者术后住院天数分别为：（4.8±2.1） d vs （3.3±1.6）d，（P<0.05）。 结论标准化情景演练模式在PCNL术后尿源性脓毒血症患者救治中有较高的应用价值，有效的提升了护理人员对尿源性脓毒血症的预判成功率，并有效缩短了护理人员的物品准备和采取有效措施时间，同时也缩短了患者住院时间。

The application value of standardized scenario training mode in the treatment of patients with urinary sepsis after PCNL

ObjectiveUrinary sepsis is one of the most dangerous complications after PCNL for patients with urinary stones, especially infectious stones. This study intends to explore the application value of standardized scenario training mode in the treatment of patients with urinary sepsis after PCNL through clinical effect evaluation. MethodsThe management records and clinical data of patients with urinary sepsis after PCNL in the department of Urology of our hospital from January 2019 to December 2020 were collected. The patients in 2019 were in the group before the application of standardized scenario training mode, and the patients in 2020 were in the group after the application standardized scenario training mode. Statistical analysis was conducted on the predictive success rate of urinary sepsis in nurses, the preparation time of rescue items, the time to take effective measures for patients, the success rate of treatment and the postoperative hospitalization time of patients respectively. ResultsBefore and after using the standardized scenario training mode, the predictive success rate of nurses on urinary sepsis after PCNL was 12.5% (1/8) vs 80.0% (8/10), (P<0.05). The average preparation time was (6.6±0.7) min vs (3.4±0.5) min, (P<0.05). The time to take effective measures was (10.8±2.0) min vs (5.0±1.6) min (P<0.05). The success rates were 75.0% (6/8) vs 90.0% (9/10) (P>0.05); The postoperative hospitalization time of patients were (4.8±2.1) days vs (3.3±1.6) days, respectively (P<0.05). ConclusionsThe standardized scenario training mode has higher application value in the treatment of patients with urinary sepsis after PCNL, which effectively improves the prediction success rate of urinary sepsis by nurses, effectively shortens the time for nurses to prepare items and take effective measures, and shortens the hospitalization time of patients.