Yılmaz Kerim Bora, Akıncı Melih, Şeker Duray, Güller Müjdat, Güneri Gürkan, Kulaçoğlu Hakan
Clinic of General Surgery, Dışkapı Teaching and Training Hospital, Ankara, Turkey.
Ulus Cerrahi Derg. 2014 Jun 1;30(2):90-2. doi: 10.5152/UCD.2014.2564. eCollection 2014.
Drains and catheters are used for both prophylactic and therapeutic reasons in clinical practice. This study aimed to investigate the factors that affect safety of drains, catheters, nasogastric tube and central venous line in patients who underwent surgery.
Two hundred and four consecutive patients who were operated at the general surgery clinics under general anesthesia were included in the study. Factors that affect the safety of drains and catheter were followed and recorded prospectively.
During follow-up period, 12 (5.8%) patients have experienced problems regarding safety of drains/catheters. The mean age of patients who were followed-up in terms of security problems was 63.1 (39-86) years. Eight (66.7%) patients had been operated emergently, and four (33.3%) patients electively. Three (25%) patients had psychiatric/neurological co-morbidities and 3 (25%) patients were confused due to anesthesia/intensive care unit treatment when the drain safety was broken. Eight (66.7%) patients withdrew the drains or catheters by themselves, in 2 (16.7%) patients the drains spontaneously came out and in 2 (16.7%) patients the wrong drain was withdrawn. One patient had dementia, one patient had Alzheimer's disease and one patient was being followed-up with a diagnosis of schizophrenia. In three (25%) patients the abdominal drain, in four (33.3%) patients nasogastric tube, in one (8.3%) patient intubation tube, in one (8.3%) patient central venous catheter, and in three (25%) patients multiple drains were removed.
The inaccurate use of drains or re-intervention for an unintentionally removed drain causes problems regarding patient safety. Close monitoring of surgical patients in terms of security, and submission of additional measures for patients with confusion and neurological/psychiatric disorders are of great importance.
在临床实践中,引流管和导管用于预防和治疗目的。本研究旨在调查影响接受手术患者的引流管、导管、鼻胃管和中心静脉导管安全性的因素。
本研究纳入了204例在全身麻醉下于普通外科门诊接受手术的连续患者。前瞻性地跟踪并记录影响引流管和导管安全性的因素。
在随访期间,12例(5.8%)患者出现了与引流管/导管安全性相关的问题。因安全问题接受随访的患者平均年龄为63.1岁(39 - 86岁)。8例(66.7%)患者为急诊手术,4例(33.3%)患者为择期手术。3例(25%)患者有精神/神经合并症,当引流管安全出现问题时,3例(25%)患者因麻醉/重症监护室治疗而出现意识模糊。8例(66.7%)患者自行拔除了引流管或导管,2例(16.7%)患者的引流管自行脱落,2例(16.7%)患者拔除了错误的引流管。1例患者患有痴呆症,1例患者患有阿尔茨海默病,1例患者被诊断为精神分裂症并接受随访。3例(25%)患者拔除了腹腔引流管,4例(33.3%)患者拔除了鼻胃管,1例(8.3%)患者拔除了气管插管,1例(8.3%)患者拔除了中心静脉导管,3例(25%)患者拔除了多个引流管。
引流管使用不当或因无意中拔除引流管而进行再次干预会导致患者安全问题。密切监测手术患者的安全性,并为意识模糊以及患有神经/精神疾病的患者采取额外措施非常重要。