Li Li, Zhou Jiangqi, Luo Likun, Chen Xiaoqing, Li Yinglan
Xinjiang Medical University,Urumqi, 830000,Xinjiang, People's Republic of China.
Nursing School, Xinjiang Medical University,Urumqi, 830000, Xinjiang, People's Republic of China.
Int J Gen Med. 2021 Sep 21;14:5949-5958. doi: 10.2147/IJGM.S322755. eCollection 2021.
To investigate the effect of the care bundle in the nursing care of the type A aortic dissection (TAAD).
A total of 161 patients with TAAD were included in the study. They were divided into control group (n=79) and care bundle group (n=82). The patients in the control group received routine nursing, while the patients in the care bundle group received routine nursing and care bundle. IL-2, IL-6 and IL-10 levels in the three periods of T0 (before anesthesia), T1 (before anesthesia to 6 h after surgery) and T2 (6-24 h after surgery), intraoperative blood loss, postoperative recovery, ICU stay time, intraoperative pressure ulcer rate, postoperative delirium rate, bloodstream infection rate and doctor satisfaction.
The postoperative T and pH levels in two groups were all in the normal range. The levels of IL-2, IL-6 and IL-10 in the care bundle group at different periods were also significantly different. The levels of IL-2 and IL-10 showed an increased trend, while that of IL-6 showed a downward trend. The intraoperative blood loss, postoperative recovery and ICU stay time, intraoperative pressure sore rate, postoperative delirium rate, and bloodstream infection rate were lower, whereas doctor satisfaction was all significantly higher in care bundle group.
Care bundle increased the safety of the operation, and it was beneficial to the postoperative rehabilitation for TAAD patients.
Patients with TAAD who underwent operation need higher quality care during the entire operation. Cluster nursing is the kind of the nursing model that can better meet the requirements of the intraoperative nursing quality. The intervention methods in this study include 5 core nursing measures. These measures are implemented together in a synergistic manner to effectively improve the quality of nursing care in operating room and the health outcomes of patients with TAAD. Care bundle is worthy of clinical application.
探讨护理集束化方案在A型主动脉夹层（TAAD）护理中的效果。
本研究共纳入161例TAAD患者。将其分为对照组（n = 79）和护理集束化组（n = 82）。对照组患者接受常规护理，护理集束化组患者接受常规护理和护理集束化方案。观察T0（麻醉前）、T1（麻醉前至术后6小时）和T2（术后6 - 24小时）三个时间段的白细胞介素-2（IL - 2）、白细胞介素-6（IL - 6）和白细胞介素-10（IL - 10）水平、术中出血量、术后恢复情况、重症监护病房（ICU）停留时间、术中压疮发生率、术后谵妄发生率、血流感染率及医生满意度。
两组术后体温及pH值均在正常范围内。护理集束化组不同时期的IL - 2、IL - 6和IL - 10水平也有显著差异。IL - 2和IL - 10水平呈上升趋势，而IL - 6水平呈下降趋势。护理集束化组的术中出血量、术后恢复情况及ICU停留时间、术中压疮发生率、术后谵妄发生率和血流感染率较低，而医生满意度显著更高。
护理集束化方案提高了手术安全性，有利于TAAD患者术后康复。
接受手术的TAAD患者在整个手术过程中需要更高质量的护理。集束化护理是一种能够更好满足术中护理质量要求的护理模式。本研究中的干预方法包括5项核心护理措施。这些措施协同实施可有效提高手术室护理质量及TAAD患者的健康结局。护理集束化方案值得临床应用。
