Hiramatsu Tamae, Sugiyama Makiko, Kuwabara Setsuko, Tachimori Yuji, Nishioka Midori
National Cancer Center Department of Nursing Administration, Tokyo, Japan.
Department of Nutrition, Omori Red Cross Hospital, Tokyo, Japan.
Am J Infect Control. 2014 Apr;42(4):385-8. doi: 10.1016/j.ajic.2013.11.017.
This historical case-control study examined the effectiveness of an outpatient preoperative care bundle on the incidence of postoperative pneumonia among patients with esophageal cancer.
We implemented a preoperative care bundle that comprised 7 care procedures that previous studies had suggested to be effective for decreasing postoperative respiratory complications, infections, postoperative hospital stay, and mortality. The care bundle group included patients who underwent surgery after the care bundle was implemented, whereas the control group included those who underwent surgery before its implementation.
The incidence of postoperative pneumonia was 3.8% in the care bundle group (1/26) and 22.4% in the control group (48/214). A logistic regression model showed that implementation of the care bundle had a significant effect on prevention of postoperative pneumonia (odds ratio, 0.16; 95% confidence interval: 0.01-0.94) after controlling the following confounding factors: sex, blood urea nitrogen, amount of blood loss, recurrent laryngeal nerve palsy, and preoperative hospital stay.
Implementation of the procedures of the preoperative care bundle was shown to be effective for preventing postoperative pneumonia in patients with esophageal cancer.
这项历史性病例对照研究探讨了门诊术前护理套餐对食管癌患者术后肺炎发生率的有效性。
我们实施了一个术前护理套餐，其中包括7项护理程序，先前的研究表明这些程序对于降低术后呼吸并发症、感染、术后住院时间和死亡率有效。护理套餐组包括在护理套餐实施后接受手术的患者，而对照组包括在其实施前接受手术的患者。
护理套餐组术后肺炎的发生率为3.8%（1/26），对照组为22.4%（48/214）。在控制了以下混杂因素后：性别、血尿素氮、失血量、喉返神经麻痹和术前住院时间，逻辑回归模型显示实施护理套餐对预防术后肺炎有显著效果（优势比，0.16；95%置信区间：0.01 - 0.94）。
术前护理套餐程序的实施被证明对预防食管癌患者术后肺炎有效。
