医护一体化内镜诊疗麻醉风险链式管理方案的构建与应用

邵晓朵; 金健威; 陈颖; 周春春; 尤熙; 张奕秉

doi:10.16766/j.cnki.issn.1674-4152.003939

医护一体化内镜诊疗麻醉风险链式管理方案的构建与应用

doi: 10.16766/j.cnki.issn.1674-4152.003939

温州市中心医院内镜中心，浙江温州 325000

基金项目:

浙江省医药卫生科技计划项目 2022KY1203

温州市科技局项目 Y2023973

详细信息

通讯作者:
邵晓朵，E-mail：shaoxiaod123@163.com

中图分类号: R616.5 R614
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- 文章访问数: 5
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- 被引次数: 0
出版历程
- 收稿日期: 2024-07-22
- 网络出版日期: 2025-05-14

Construction and application of integrated endoscopic anesthesia risk chain management scheme for medical care

Endoscopy Center, Wenzhou Central Hospital, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的构建医护一体化内镜诊疗麻醉风险链式管理方案，并进行临床应用，探讨其对患者麻醉不良反应、焦虑状态和满意度的影响。方法选择2023年4—6月在温州市中心医院内镜中心就诊的300例患者为对照组，选择2023年7—9月在该院内镜中心就诊的300例患者为干预组。对照组采取由麻醉师负责的常规麻醉管理，干预组在对照组基础上实施医护一体化内镜诊疗麻醉风险链式管理方案，比较2组患者麻醉不良反应的发生率、焦虑评分和对内镜诊疗麻醉工作的满意度。结果干预组麻醉中低血氧、恶心呕吐、呛咳、反流误吸的发生率低于对照组，差异均有统计学意义(P＜0.05)；但2组患者心律失常、呼吸抑制的发生率差异均无统计学意义(P＞0.05)。干预前2组患者焦虑评分差异无统计学意义(P＞0.05)，干预后2组患者焦虑评分较干预前均明显下降(P＜0.01)，且干预组焦虑评分[(33.45±4.78)分]低于对照组[(38.90±6.09)分]，差异有统计学意义(F=15.290, P＜0.001)。干预组患者对内镜诊疗麻醉各方面的满意度均高于对照组，差异有统计学意义(P＜0.01)。结论医护一体化链式管理方案有利于减少内镜诊疗麻醉不良事件的发生，减轻患者对内镜诊疗的焦虑，提高满意度。
- 内镜诊疗 /
- 麻醉 /
- 链式管理 /
- 医护一体化
Abstract: Objective A risk chain management scheme for integrated medical and nursing endoscopic diagnosis and treatment of anesthesia is constructed and clinically applied, and its influence on patients ' anesthesia adverse reactions, anxiety state and satisfaction is discussed. Methods A total of 300 patients treated at the Endoscopy Center of Wenzhou Central Hospital from April to June 2023 were selected as the control group, and 300 patients treated from July to September 2023 were selected as the intervention group. Patients in the control group underwent routine anesthesia management by anesthesiologists, while the intervention group implemented an integrated anesthesia risk chain management scheme based on the control group, including the establishment of an endoscopic anesthesia risk chain management team, the construction of the management scheme and the implementation of the scheme, and compared the incidence of anesthesia adverse reactions, anxiety scores and satisfaction with endoscopic anesthesia in the two groups. Results In terms of adverse reactions, the incidence of hypoxia, nausea and vomiting, cough and reflux aspiration in the intervention group was significantly lower than that in the control group, with statistical significance (P < 0.05). However, there was no significant difference in the incidence of arrhythmia and respiratory depression between the two groups (P > 0.05). In terms of anxiety scores, there was no statistically significant difference between the two groups before treatment (P > 0.05). After treatment, the anxiety scores of the two groups were significantly decreased (P < 0.01), however, the anxiety score of the intervention group (33.45±4.78) was lower than that of the control group (38.90±6.09), with statistical significance (F=15.290, P < 0.001). In terms of satisfaction, the satisfaction of patients in the intervention group was higher than that in the control group, and the difference was statistically significant (P < 0.01). Conclusion The integrated chain management scheme of medical care is conducive to reducing the occurrence of adverse anesthesia events in endoscopic diagnosis and treatment, reducing patients ' anxiety about endoscopic diagnosis and treatment, and improving their satisfaction.
- Endoscopic diagnosis and treatment /
- Anesthesia /
- Chain management /
- Integration of medical care

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图 1 医护一体化内镜诊疗麻醉风险链式管理环节

Figure 1. Chain management of anesthesia risk in integrated endoscopic diagnosis and treatment

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表 1 2组患者麻醉不良反应发生率比较[例(%)]

Table 1. Comparison of the incidence of adverse anesthetic reactions between the two groups [cases(%)]

组别	例数	麻醉中低血氧	恶心呕吐	呛咳	心律失常	反流误吸	呼吸抑制
对照组	300	40(13.33)	35(11.67)	42(14.00)	7(2.33)	22(7.33)	7(2.33)
干预组	300	21(7.00)	17(5.67)	24(8.00)	5(1.67)	8(2.67)	5(1.67)
χ²值		6.588	6.822	5.516	0.340	6.877	0.340
P值		0.010	0.009	0.019	0.560	0.009	0.560

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表 2 2组患者干预前后焦虑评分比较(x±s, 分)

Table 2. Comparison of anxiety scores before and after intervention between the two groups (x±s, points)

组别	例数	干预前	干预后	t值	P值
对照组	300	46.46±4.56	38.90±6.09	17.211	＜0.001
干预组	300	46.11±5.18	33.45±4.78	31.110	＜0.001
统计量		0.878^a	15.290^b
P值		0.380	＜0.001
注：^a为t值，^b为F值。

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表 3 2组患者对内镜诊疗麻醉工作的满意度比较(x±s, 分)

Table 3. Comparison of patients ' satisfaction with endoscopic diagnosis, treatment and anesthesia between the two groups (x±s, points)

组别	例数	诊疗流程	专业技术	人文关怀	健康宣教	整体服务
对照组	300	3.32±0.77	2.83±0.85	2.89±0.81	3.39±0.89	2.84±0.82
干预组	300	4.40±0.59	4.05±0.68	4.10±0.67	4.60±0.52	4.06±0.74
t值		19.284	19.412	19.937	20.332	19.131
P值		＜0.001	＜0.001	＜0.001	＜0.001	0.006

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