基于生存分析的中医护理干预对留置针并发症的疗效观察

The curative effect of Chinese medicine nursing intervention on complications of indwelling needle based on survival analysis

关键词:  中医护理干预  留置针并发症  生存分析

Key words:  Chinese medicine nursing intervention  complication of indwelling needle  survival analysis

摘要:

[目的] 基于生存分析探索中医护理干预对留置针并发症的疗效。[方法] 选取2018年9-12月在天津中医药大学第二附属医院运用留置针输液的住院患者为研究对象。采用便利整群抽样的方法选取样本，随机分为对照组及干预组。对照组实施常规留置针护理，干预组在常规护理基础上实施中医护理干预，包括红肿消外敷、穴位按摩及坐式十二段锦中的第九图"两脚放舒伸，叉手双虚托"进行肢体训练。不同组别生存分析采用Kaplanmeier曲线描述。影响生存的危险性多因素采用Cox生存模型进行分析。[结果] 留置针患者发生并发症的时间多集中在留置后50~100 h，对照组中位生存时间为81.75 h，干预组中位生存时间为127.00 h，两组比较差异有统计学意义（P<0.01）。组别和文化程度是留置针留置时间的独立影响因素。[结论] 该研究所应用的中医护理方案可明显降低留置针并发症的发生，并延长留置时间。护理人员可通过中医护理干预及加强健康教育的方法延长留置时间，尤其在留置后50~100 h内进行收效较好。

Abstract:

[Objective] To explore the curative effect of Chinese medicine nursing intervention on complications of indwelling needle based on survival analysis.[Methods] The indwelling needle infusion of hospitalized patients were selected from Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine(TCM) between September 2018 to December 2018,and they were randomly divided into control group and intervention group. Patients in the control group received conventional nursing,patients in intervention group received implementation of TCM nursing intervention on the basis of conventional nursing,including external application of redness and swelling,acupoint massage and sitting-style twelve-duanjin in the ninth picture "relax and stretch both feet,and cross hands and double virtual support" for physical training. Using survival analysis and Cox survival model as statistical analysis method.[Results] Complications of indwelling needle occurred frequently after indwelling 50~100 h,and the median survival time was 81.75 h in the control group and 127.00 h in the intervention group,the difference was statistically significant (P<0.001). Group and educational level were independent factors affecting needle indwelling time.[Conclusion] The TCM nursing scheme applied in this study can significantly reduce the incidence of complications of indwelling needles,and extend the indwelling time. Nursing staff can extend the indwelling time by TCM nursing intervention and strengthening health education,especially within 50~100 h after indwelling,the effect is better.