| Objective:To probe the effects of two types of oral-nasal and oropharyngeal nursing measures in patients undergoing gastric intubation after gastroscope operation.Methods:A total of78patients who underwent indwelling gastric tube after gastroscope operation under the general anesthesia in Shandong provincial hospital from October,2012to December,2013, in accordance with the random number table, were divided into two groups with40cases assigned to.experimental group and38cases to control group. The surgical types among78patients included ESE in peases, ESD in33cases, STER in19cases and POEM in17cases, respectively. We used the routine oral-nasal nursing care, twice a day, plus the oxygen aerosol inhalation of hydrochloric acid ambroxol30mg+normal saline6ml, twice a day, the nasal drip of compound menthol nasal drops,3-4drops each time,4times a day and a replacement of3M herringbone pressurized fixed tape,1time a day in patients of experimental group; for patients of control group, we gave the routine oral-nasal nursing care, twice a day, plus oxygen aerosol inhalation of gentamicin8miU+dexamethasone5mg+normal saline7ml, twice a day, the nasal drip of paraffin oil,3-4drops each time,4times a day and the replacement of3M herringbone pressurized fixed tape when its viscosity was decreased. Then we evaluated all the patients with GCQ scale of Kolcaba and visual algetic mimic scale (VAS) and made a corresponding comparison of comfort level and pain degree of oral cavity and nasopharynx and the incidence of adverse reaction, gastric tube shift and dislocation, pressure ulcer in two groups. SPSS17.0software was used for data entry and analysis; statistical methods included descriptive statistics analysis, analysis of variance, t test, chi-square test and Fisher exact probability method.Results:78cases were enrolled in this study with40cases assigned randomly to experimental group and38cases to control group. No statistical differences were found in age, sex, disease entity, surgical methods, operation and gastric intubation duration and comfort scoring before gastric tube insertion (P>0.05). The research results about postoperative adverse reaction, comfort scoring, pain scoring, pressure ulcer, gastric tube shift and dislocation were as follows:1. The incidence of adverse reaction such as dryness and pain of oral cavity and nasopharynx, difficult expectoration, expressive language disorder and restricted head and neck activities, in72h after gastric intubation in experimental group was obviously lower than that in control group with the difference statistically significant (P<0.05).No statistical difference was found in bad breath(P>0.05).2. By horizontal comparison, the average comfort scoring in24h,48h,72h after gastric intubation in experimental group was higher respectively than the corresponding value in control group with the difference statistically significant (t=2.317, P<0.05;t=3.415, P<0.01;t=4.612, P<0.01); during the gastric intubation, the average comfort scoring of each dimension in experimental group patients was higher than that in control group patients (physiological dimension: t=8.207, P<0.01; psychological dimension:t=15.724, P<0.01; social dimension:t=6.537, P<0.01; environmental dimension: t=6.676, P<0.01) with the statistical difference found; by vertical comparison, the comfort scoring in both groups was rising along with the extension of time (F=88.156, P<0.01), while the rising trend in experimental group was faster than that in control group (F=55.886, P<0.01), and the statistical difference in the aspect of comfort scoring between the groups was found, either (F=17.927, P<0.01).3. By horizontal comparison, the average pain scoring in24h,48h,72h after gastric intubation in experimental group was lower than that in control group (t=-2.789, P<0.01;t=-3.782, P<0.01;t=-2.461, P<0.05) and the statistical difference was found; by vertical comparison, the pain scoring in both groups was declined along with the extension of time (F=31.595, P<0.01), while the downtrend in experimental group was faster than that in control group (F=53.691, P<0.01), and the statistical difference in the aspect of pain scoring between the groups was found (F=9.569, P<0.05).4. Compared to the control group, the incidence of pressure ulcer, gastric tube shift and dislocation in experimental group was significantly lower (x2=7.577, P<0.01; x2=4.130, P<0.05).Conclusions:It can effectively alleviate the discomfort of oral cavity and nasopharynx and decrease the incidence of pressure ulcer,gastric tube shift and dislocation to give routine oral-nasal nursing care,2times a day plus the oxygen aerosol inhalation of hydrochloric acid ambroxol30mg+normal saline6ml,2times a day, the nasal drip of compound menthol nasal drops,3-4drops each time,4times a day and a daily replacement of3M herringbone pressurized fixed tape to patients who underwent indwelling gastric tube after gastroscope operation. |
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