术前体验式护理联合麻醉苏醒护理对减轻HoLEP术患者全麻苏醒期躁动的效果分析

  目的  探讨术前体验式护理联合麻醉苏醒护理对减轻经尿道前列腺钬激光剜除(HoLEP)术患者全麻苏醒期躁动的临床效果。  方法  纳入三六三医院2018年11月—2019年11月实施HoLEP术的患者108例，采用随机数字表法分为观察组和对照组各54例，观察组采用术前体验式护理联合麻醉苏醒护理，对照组采用传统护理。比较2组患者进入麻醉复苏室30 min时心率、血压、躁动发生率、非计划再次手术率、术后1 d尿道舒适度及护理满意度。  结果  观察组进入麻醉复苏室30min时心率[(78.41±6.23) 次/min vs. (89.35±7.91)次/min, t=7.613, P=0.018]、血压[收缩压(132.17±11.36) mm Hg(1 mm Hg=0.133 kPa) vs. (148.56±10.25) mm Hg, t=10.385, P=0.013；舒张压(86.34±7.83) mm Hg vs. (98.62±10.16) mm Hg, t=8.352, P=0.016]与对照组相比较，差异有统计学意义(均P＜0.05)。观察组全麻苏醒期躁动发生率(12.96%)明显低于对照组(35.19%，P=0.025)。观察组非计划再次手术率(1.85%)低于对照组(5.56%，P=0.219)。观察组术后1 d尿道舒适度(85.19%)显著高于对照组(70.37%，P=0.031)。观察组护理满意度(96.30%)明显高于对照组(87.04%，P=0.047)。  结论  对于无留置尿管病史需全麻行HoLEP术患者，术前体验式护理联合麻醉苏醒护理能减轻全麻苏醒期躁动，减缓尿道不适感，提高护理满意度，值得推广应用。 

Effect analysis of preoperative experiential nursing combined with anesthesia recovery nursing to reduce emergence agitation in patients undergoing HoLEP

  Objective  To investigate clinical effect of preoperative experiential nursing combined with anesthesia recovery nursing to reduce emergence agitation in patients undergoing holmium laser enucleation of the prostate (HoLEP).  Methods  Totally 108 patients undergoing HoLEP in 363 hospital from November 2018 to November 2019 were randomized into experimental group and control group by random number method, 54 cases each group. The experimental group received preoperative experiential nursing combined with anesthesia recovery nursing, and the control group received routine nursing care. The blood pressure and heart rate 30 minute after entering anesthesia recovery room, incidence of agitation, incidence of unplanned reoperation, urethra comfort postoperative 1 d and nursing satisfaction were compared between the two groups.  Results  The blood pressure [systolic pressure (132.17±11.36) mm Hg(1 mm Hg=0.133 kPa) vs. (148.56±10.25) mm Hg, t=10.385, P=0.013; diastolic pressure (86.34±7.83) mm Hg vs. (98.62±10.16) mm Hg, t=8.352, P=0.016] and heart rate [(78.41±6.23) times/min vs. (89.35±7.91) times/min, t=7.613, P=0.018] 30 minute after entering anesthesia recovery room in the experimental group was significantly lower than the control group (all P < 0.05). The incidence of agitation was significantly less in the experimental group than that in the control group (12.96% vs. 35.19%, P=0.025). The incidence of unplanned reoperation was lower in the experimental group than the control group (1.85% vs. 5.56%, P=0.219). The urethra comfort postoperative 1 d was significantly higher in the experimental group than the control group (85.19% vs. 70.37%, P=0.031). The nursing satisfaction was significantly higher in the experimental group than the control group (96.30% vs. 87.04%, P=0.047).  Conclusion  For no-catheter history patients undergoing HoLEP, preoperative experiential nursing combined with anesthesia recovery nursing can reduce emergence agitation, relieve urethral irritation and increase nursing satisfaction, it is worth clinical spreading.