The Whole Nursing Intervention Research On The Prevention Of Intraoperative Pressure Sores On The Patients Operated With Endoscopic Esophageal Carcinoma Radical Resection

Purpose:To discuss the whole nursing intervention plan on the prevention of intraoperative pressure sores on the patients operated with endoscopic esophageal carcinoma radical resection.Methods:This is a quasi-experimental research.132 patients from February in 2017 to September in 2017 in the thoracic surgery department of a first class tumor hospital in Henan were selected,who were operated with endoscopic esophageal carcinoma radical resection because of esophageal carcinoma and who met the inclusion criteria,and the they were divided into the intervention group and control group using convenient sampling,the intervention group was in the first ward of thoracic surgery department and the control group in the second ward.66 patients were in the control group and intervention group respectively.The control group was operated with the normal methods to prevent intraoperative pressure sores,the intervention group was operated with whole nursing methods based on normal ways,including:(1)establishing protection teams on pressure sore who were trained with pressure sore knowledge,NRS scores,using of operation table,patient positioning,operative process and etc.(2)the teams evaluated the skin of patients and filled the Skin Nursing Paper of Operating Patients according to the flow chart of whole nursing methods: operated NRS scores on the patients preoperatively to confirm their nutritional conditions;operated skin care intervention intraoperatively(to regulate the surgical operation and process of patient positioning,to use inflatable warming blanket and etc);postoperatively evaluated the pressure sores immediately and operated nursing measures in time;took follow-up visits on the patients with pressure sores 6 hours and 24 hours after the surgery.Then the basic data,patient positioning time,total operative time,intraoperative bleeding volume,the occurrence rate of intraoperative low body temperature,the occurrence of pressure sores within 24 hours,satisfaction degree of nurses' coordination in the operation room of two groups were collected.Then they were organized and entered into the database,SPSS19.0 was applied for statistical treatment,accurate analysis was operated including t-test,chi-squared test and etc,in order to judge the prevention effect of intraoperative pressure sores by the way of whole nursing methods on the patients who were operated with endoscopic esophageal carcinoma radical resection and to get the whole nursing intervention plan to prevent intraoperative pressure sores on the patients.Results:1.The occurrence rate of pressure sores postoperatively within 24 hours was examined by t-test,which of the control group was 25.76%,the intervention group was 10.61%,and the difference under the chi-squared test showed statistical significance(P=0.024);the difference on the pressure sore staging between intervention group and control group under chi-square test showed no statistical significance,primary pressure sores(P=0.118),secondary pressure sores(0.090).2.Intraoperative patient positioning time,total operative time and intraoperative bleeding volume were examined by t-test.The difference on the intraoperative patient positioning time and total operative time between the intervention group amd control group under t-test showed statistical significance,intraoperative patient positioning time(P=0.034),total operative time(P=0.021);intraoperative bleeding volume of control group was 36.32±9.42(ml),the intervention group was 33.85±8.25(ml),the difference under t-test showed no statistical significance(P=0.111).3.The comparison on intraoperative body temperature using inflatable warming blanket was examined by t-test.The oropharyngeal temperature in the anesthesia process and skin cut procedure of patients in both groups was examined by t-test,the difference showed no statistical significance(P>0.05),which can be compared;the oropharyngeal temperature of intervention group and control group was examined by t-test postoperatively,and the difference showed statistical significance(P=0.000);the occurrence condition of intraoperative low body temperature of patients in both groups was examined by chi-square test,and the difference showed statistical significance(P=0.032).4.The comparison on the professional ability of nurses in pressure sore protection teams,survey on the satisfaction degree of nursing coordination in the operation room were examined by t-test and chi-square test.The professional knowledge and operating skills on pressure sore prevention in control group and intervention group was examined by t-test,the satisfaction degree of nursing coordination in the operation room was examined by chi-square test,both difference showed statistical significance(P<0.05).Conclusions:1.The whole surgical nursing intervention plan could improve the condition as high occurrence rate of intraoperative pressure sores in endoscopic esophageal carcinoma radical resection.2.Establishing pressure sore protection teams could improve the professional ability of nurses in the operating room and satisfaction degree of nursing coordination in the operating room,also reduce the unfavorable factors that affected operative time,and improve nursing quality.3.Using inflatable warming blanket intraoperatively could effectively improve the body temperature condition of patients,and reduce the occurrence rate of intraoperative low body temperature.4.The preoperative,intraoperative and postoperative evaluation and operating measures operated by nurses in the operating room were recorded on the Skin Nursing Paper of Operating Patients in the form of tables,which could further remind and supervise nurses to perfectly do the prevention work of intraoperative pressure sores,convenient for the ward nurses to know the conditions of patients intraoperatively.