文章摘要
引用本文:徐琼 吴祝凤 杨楠楠 石莫.Bakri球囊管理循证实践在前置胎盘产后出血患者中的应用效果[J].中国护理管理,2018,18(12):1608-1612 本文二维码信息
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Bakri球囊管理循证实践在前置胎盘产后出血患者中的应用效果
An evidence-based practice: the management of Bakri balloon in the control of postpartum hemorrhage caused by placental previa
  
DOI:10.3969/j.issn.1672-1756.2018.12.005
中文关键词:  产后出血  球囊  循证护理  效果
English Keywords:postpartum hemorrhage  Bakri balloon  evidence-based nursing  effect
基金项目:广州市科技计划项目(201607010222)
作者单位
徐琼 吴祝凤 杨楠楠 石莫 广州市妇女儿童医疗中心产科510000 
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中文摘要:
      目的:寻找目前与Bakri球囊相关的前置胎盘产后出血防治管理的最佳证据,并将最佳证据应用于护理实践中,探讨循证护理在Bakri球囊防治前置胎盘产后出血中应用的效果。方法:运用循证方法得出最佳证据,结合团队临床经验及患者需求制订Bakri球囊护理审查标准、临床护理规范、风险预警流程,对所有医护人员进行最佳证据的培训,并将其应用于Bakri球囊护理管理,比较循证实践前后患者止血成功率、置管并发症(生殖道感染、脱管、移位、拔管后出血)发生率以及住院时间、24 h出血量情况。结果:最佳证据应用后患者止血成功率由84.0%上升为100.0%;生殖道感染、脱管、堵管、移位等并发症的发生率由24.0%下降为4.0%,差异有统计学意义(P<0.05);同时循证实践后的患者24 h出血量及住院时间均少于循证实践前的患者,差异存在统计学意义(P<0.05)。结论:对前置胎盘患者应用Bakri球囊防治出血疗效显著,术后采用循证护理实践,可明显提高球囊止血成功率,降低球囊脱管、堵管、移位等并发症发生率,同时降低患者24h出血量及缩短住院时间。
English Summary:
      Objective: To search evidence-based nursing practices relevant to Bakri balloons in prevention and management of postpartum hemorrhage caused by placental previa at present and their effectiveness, and apply those practices to clinical nursing. Methods: Evidence-based methods were adopted to figure out the best evidence, which was then combined with the medical team members' clinical experience and patients' requirement to make review standards and clinical nursing norms of Bakri balloons and risk warning processes of postpartum hemorrhage. All medical staff were trained about the best practice as well as the above mentioned standards, norms and processes to ensure their application to Bakri balloons usage management. Indicators collected before and after the application of Bakri balloons, including the success rate of hemostasis, incidence of relevant complications (such as genital tract infection, balloons knockout and displacement, and hemorrhage after extubation), hospital stay and hemorrhage within 24 hours were compared and analyzed. Results: The success rate of hemostasis increased from 84.0% to 100.0% since the implementation of the evidence-based practice, with the incidence of complications decreased from 24.0% to 4.0%, which was significantly lower than before (P<0.05). Meanwhile, patients's hospital stays and the amount of hemorrhage within 24 hours both decreased after the implementation of the evidence-based practice with the differences being statistically significant (P<0.05). Conclusion: Bakri balloons were significantly useful in controlling hemorrhage caused by placenta previa, and application of evidence-based practices to women after their operations can obviously improve the success rate of hemostasis, reduce the incidence of complications and hemorrhage within 24 hours, and shorten their hospital stays.
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