摘要目的 探讨护理干预对胸椎结核经胸入路手术患者肺功能的影响.方法 将80例拟行经胸入路胸椎结核手术患者随机分为干预组和对照组各40例,对照组术前、术后采用常规护理,干预组在常规护理的基础上进行综合护理干预,于入院第1天,术后1d,术后7d分别对两组患者进行肺功能检测、动脉血气分析,比较肺活量(VC)、最大通气量(MVV)、1秒用力呼气容量(FEV1)、1秒量比用力肺活量(FEV/FVC)、动脉血氧分压(PaO2),动脉二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2).结果 两组患者入院第1天各项肺功能指标比较,差异无统计学意义(P＞0.05),术后1d、7d干预组VC(t分别为6.326,5.276)、MVV(t分别为5.958,4.742)、FEV1(t分别为5.656,4.356)、FEV1/FVC(t分别为5.066,4.866)、PaO2(t分别为8.937,6.837)、SaO2(t分别为5.213,4.113)均高于对照组,PaCO2低于对照组[(48.7±3.1)％比(40.7±2.5)％,(44.3±3.2)％比(38.2±2.4)％],差异均具有统计学意义(t分别为3.157,2.557;P＜0.05).结论 综合护理干预能有效改善经胸入路胸椎结核手术患者的肺功能,预防肺部并发症.

abstractsObjective To explore the effect of nursing intervention on the pulmonary function of patients having thoracic tuberculosis transthoracic approach surgery.Methods 80 cases of patients who were to have thoracic tuberculosis transthoracic approach surgery were randomly divided into the intervention group and the control group,each with 40 cases.The control group received conventional nursing before and after operation,while the intervention group received nursing intervention in addition.Their pulmonary function,arterial blood gas analysis,comparison of vital capacity (VC),maximal ventilatory volume (MVV),forced expiratory volume in one second (FEV1),a second volume than the forced vital capacity (FEV1/FVC),arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2) and arterial oxygen saturation (SaO2) were compared on the 1st day in hospital,1st and 7th day after operation.Results The indicators of pulmonary function on the 1st day in hospital had no significant differences between two groups (P ＞ 0.05).The VC (t =6.326,5.276,respectively),MVV (t =5.958,4.742,respectively),FEV1 (t =5.565,4.356,respectively),FEV1/FVC (t =5.066,4.866,respectively),PaO2 (t =5.213,4.113,respectively) and SaO2 (t =8.937,6.837,respectively) on the 1st and 7th day after operation were all higher in the intervention group than in the control group,while the PaCO2 was higher in the control group than in the intervention group [(48.7 ± 3.1) ％ vs (40.7 ± 2.5) ％,(44.3 ± 3.2) ％ vs (38.2 ± 2.4) ％],and the differences were statistically significant (t =3.157,2.557,respectively ; P ＜ 0.05).Conclusions Integrated nursing intervention can effectively improve the pulmonary function of patients having thoracic tuberculosis transthoracic approach surgery,and prevent pulmonary complications.