介入手术机床约束床单的设计及应用

doi:10.3761/j.issn.2096-7446.2023.06.018

摘要/Abstract

摘要： 目的自制介入手术机床约束床单并评价其应用效果。方法介入手术机床约束床单由床单本体、绑带、活动带、四肢固定带组成。便利选取浙江省某三级甲等综合医院微创介入科行全身麻醉下颅内动脉机械取栓术的100例急性缺血性卒中患者,其中2022年6月—10月的50例患者为试验组,使用介入手术机床约束床单;2022年1月—5月的50例患者为对照组,不进行约束。比较两组患者入导管室至股动脉穿刺时间、术中不良事件发生率的差异。结果试验组入导管室至股动脉穿刺时间（15.60±3.34）min小于对照组（25.98±5.50）min,差异具有统计学意义（t=-11.406,P<0.001）;两组均未发生不良事件。结论介入手术机床约束床单操作安全,缩短患者入导管室至股动脉穿刺时间。

关键词: 缺血性卒中, 放射学, 介入性, 约束, 身体的, 手术中护理

Abstract: Objective To design the machine bed restraint sheets for interventional surgery and evaluate the application effects. Methods Machine bed restraint sheets for interventional surgery was composed of sheet body,straps,mobile straps,and extremity fixation straps. We conveniently selected 100 patients with acute ischemic stroke who underwent mechanical intracranial thrombectomy under general anesthesia in minimally invasive interventional department of a Grade-Ⅲ general hospital in Zhejiang Province. 50 patients from June to October 2022 were selected as experimental group and the restraint bed sheets were used. 50 patients from January to May 2022 were selected as control group without restraint. The time from catheter lab to femoral artery puncture and the incidence of intraoperative restraint-related adverse events were compared between the two groups. Results The time from catheter lab to femoral artery puncture of experimental group was（15.60±3.34）min which was shorter than that of control group（25.98±5.50）min. The difference was statistically significant（t=-11.406,P<0.001）. No restraint related adverse events occurred in both groups. Conclusion The machine bed restraint sheets are safety to operate,which can shorten the time from catheter lab to femoral artery puncture.

Key words: Ischemic Stroke, Radiology, Interventional, Restraint, Physical, Intraoperative Care

金浙夏, 陈仁彪, 章雁, 吴春俏, 赵添, 董健. 介入手术机床约束床单的设计及应用[J]. 中华急危重症护理杂志, 2023, 4(6): 573-576.

JIN Zhexia, CHEN Renbiao, ZHANG Yan, Wu Chunqiao, ZHAO Tian, DONG Jian. Design and application of machine bed restraint sheets for interventional surgery[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(6): 573-576.

参考文献

[1] 李冬梅,陆小英,钱火红,等. 卒中急救护士统筹协调急性缺血性卒中一体化救治流程的实践[J]. 中华急危重症护理杂志,2020,1(5):405-409.
Li DM,Lu XY,Qian HH,et al.Practice of integrated treatment process of acute ischemic stroke coordinated by stroke emer-gency nurses[J]. Chin J Emerg Crit Care Nurs,2020,1(5):405-409.
[2] 张圣,史宗杰,王振,等. 院前通知对急性颅内大动脉闭塞患者取栓流程及疗效的影响[J]. 中国卒中杂志,2018,13(2):106-113.
Zhang S,Shi ZJ,Wang Z,et al.The impact of prehospital notification on door-to-reperfusion time and clinical outcome after thrombectomy[J]. Chin J Stroke,2018,13(2):106-113.
[3] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组,中华医学会神经病学分会神经血管介入协作组. 中国急性缺血性卒中早期血管内介入诊疗指南2022[J]. 中华神经科杂志,2022,55(6):565-580.
Neurology Branch of Chinese Medical Association,Cerebrovascular Group of Neurology Branch of Chinese Medical Association,Neurovascular Intervention Collaboration Group of Neurology Branch of Chinese Medical Association. Chinese guidelines for the endovascular treatment of acute ischemic stroke 2022[J]. Chin J Neurol,2022,55(6):565-580.
[4] Powers WJ,Rabinstein AA,Ackerson T,et al.2018 Guidelines for the early management of patients with acute ischemic stroke:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke,2018,49(3),e46-e110.
[5] 郭修凯,姜秀霞,张瑞敏,等. 移动卒中单元救治流程的优化及应用效果[J]. 中华护理杂志,2021,56(8):1145-1150.
Guo XK,Jiang XX,Zhang RM,et al.Effect of optimization of mobile stroke unit treatment process on patients with acute ischemic stroke[J]. Chin J Nurs,2021,56(8):1145-1150.
[6] 梁宏艳,赵文博,马红蕊,等. 急性缺血性卒中取栓治疗延误的影响因素分析[J]. 中国脑血管病杂志,2020,17(2):57-62,97.
Liang HY,Zhao WB,Ma HR,et al.Multivariate analysis of delay of acute ischemic stroke treated with endovascular throm-bectomy[J]. Chin J Cerebrovasc Dis,2020,17(2):57-62,97.
[7] 洪慧,闫丹萍,王钰炜,等. 急性缺血性卒中患者溶栓流程的优化及效果评价[J]. 中华急危重症护理杂志,2022,3(4):354-359.
Hong H,Yan DP,Wang YW,et al.Optimization and effect evaluation of emergency procedures for patients with acute stroke[J]. Chin J Emerg Crit Care Nurs,2022,3(4):354-359.
[8] 陆秋芳,应燕萍,覃艳勤,等. 急性期脑卒中患者下肢深静脉血栓风险预测模型的构建及应用[J]. 中华护理杂志,2022,57(16):1948-1955.
Lu QF,Ying YP,Qin YQ,et al.Establishment of a nomogram model for predicting the risk of deep vein thrombosis in patients with acute stroke[J]. Chin J Nurs,2022,57(16):1948-1955.
[9] 中华医学会神经病学分会,中华医学会神经病学分会神经血管介入协作组. 介入神经病学导管室构建与管理中国专家共识[J]. 中华神经科杂志,2019,52(4):247-251.
Neurology Branch of Chinese Medical Association,Neurovascular Intervention Collaboration Group of Neurology Branch of Chinese Medical Association. Chinese expert consensus on the construction and management of cerebrovascular intervention center[J]. Chin J Neurol,2019,52(4):247-251.
[10] 李爱仙,华亚芳,陶娟,等. 自制防护布单的研制与临床应用效果观察[J]. 中国实用护理杂志,2016,32(3):204-205.
Li AX,Hua YF,Tao J,et al.Development of self-made protective cloth sheet and observation on clinical application effect[J]. Chin J Pract Nurs,2016,32(3):204-205.
[11] Christie A,Robertson I.A survey of nurse staffing levels in interventional radiology units throughout the UK[J]. Clin Radiol,2016,71(7):698-701.
[12] 吴慧颖,杨斌,车宏伟. 机动护士规范化培训在手术室护理中的应用价值[J]. 中国实用护理杂志,2021,37(26):2058-2062.
Wu HY,Yang B,Che HW.Application value of standardized training of mobile nurses in operating room nursing[J]. Chin J Pract Nurs,2021,37(26):2058-2062.
[13] 胡千桃,郭子君. 手术麻醉信息管理系统中风险预警的构建及应用[J]. 中华护理杂志,2018,53(6):687-691.
Hu QT,Guo ZJ.Establishment and evaluation of early risk warning in electronic nursing information system for operating room[J]. Chin J Nurs,2018,53(6):687-691.
[14] 张帅,陈娟红,全殷殷,等. ICU患者身体约束管理系统的构建与应用[J]. 中华护理杂志,2023,58(1):55-59.
Zhang S,Chen JH,Quan YY,et al.Construction and application of a physical restraint management system for ICU patients[J]. Chin J Nurs,2023,58(1):55-59.
[15] 崔念奇,甘秀妮,金静芬,等. 6项核心策略模型在ICU患者身体约束缩减行动中的应用研究[J]. 中华急危重症护理杂志,2020,1(1):24-30.
Cui NQ,Gan XN,Jin JF,et al.Effects of physical restraint reduction interventions based on 6 Core Strategies among pa-tients in ICU[J]. Chin J Emerg Crit Care Nurs,2020,1(1):24-30.