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目的分析胸外科常见危急值的种类及原因,探讨其护理对策。方法收集2013年1月-12月四川大学华西医院胸外科报告的所有危急值,结合患者的临床资料进行分析,针对形成原因探讨相应的护理对策,并完善危急值的管理制度。结果危急值报告共93例次涉及82例患者,其中7例患者多次出现危急值,出现2例次危急值4例,出现3例次危急值2例,出现4例次危急值1例。排除4例次假性危急值后,其余89例次危急值发生情况:血钾异常(>6.0或<3.0 mmol/L)72例次(80.90%),血糖异常(>18.0或<2.8 mmol/L)11例次(12.36%),血培养阳性3例次(3.37),人类免疫缺陷病毒阳性2例次(2.25%),凝血功能异常1例次(1.12%)。结论胸外科常见的危急值与术后应激状态及电解质失衡有关,提供针对性的护理对策,落实危急值报告规范,对保证术后患者的安全和康复有重要意义。
Objective To analyze the types and causes of common critical values of thoracic surgery and discuss the nursing countermeasures. Methods All the critical values reported from the Department of Thoracic Surgery, West China Hospital, Sichuan University from January to December 2013 were collected and analyzed according to the clinical data of the patients. The corresponding nursing measures were discussed according to the cause of formation and the management system of critical value was improved. Results A total of 93 cases of critical value were reported in 82 patients. Among them, 7 patients had multiple critical values, 2 sub-critical values occurred in 4 cases, 3 sub-critical values occurred in 2 cases and 4 sub-critical values occurred in 1 case. Excluding the four cases of hypokalemia, the remaining 89 cases were classified as critical risk factors: blood potassium abnormalities (> 80.0%), blood glucose abnormalities (> 18.0 or <2.8 mmol / 11 cases (12.36%), 3 cases (3.37) positive for blood culture, 2 cases (2.25%) positive for human immunodeficiency virus and 1 case (1.12%) with coagulation abnormality. Conclusion The common critical values of thoracic surgery are related to postoperative stress status and electrolyte imbalance, providing targeted nursing strategies and implementing the critical value reporting standards, which are of great significance for ensuring postoperative patients’ safety and rehabilitation.