评价对多发肋骨骨折合并血气胸患者接受胸腔闭式引流术(CTD)治疗期间进行全面综合护理干预的护理质量。

回顾性分析2014年1月至2015年10月日照市五莲县人民医院住院接受CTD治疗的42例多发肋骨骨折合并血气胸患者其中男性27例，女性15例；年龄18～68岁，平均(45.32±5.43)岁。对比观察在常规护理的基础上，规范引流管护理操作并加强对患者的呼吸道管理、疼痛护理、心理护理、饮食护理和并发症预防等全面综合性护理干预后，患者排痰难易程度、疼痛程度、心理状态、术后并发症发生率和患者满意度的变化。

护理干预后患者的排痰难度较干预前显著降低，差异有统计学意义(P<0.05)。干预后患者视觉模拟评分(VAS)及严重程度分级、汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分均显著降低[VAS评分：(3.12±0.41)分vs (8.65±0.64)分；HAMA评分：(22.34±4.69)分vs (46.32±5.68)分；HAMA评分：(29.31±4.42)分vs (47.43±6.82)分]差异有统计学意义(P均<0.05)。42例患者的引流管留置时间为(66.78±1.59)h，住院期间均未发生胸腔感染、皮下气肿以及引流管脱管等并发症。患者对护理总满意度为100%(42/42)。

在多发肋骨骨折拌血气胸患者的CTD中开展精心的护理干预能够减轻疼痛，降低并发症感染率等。

To evaluate the quality of comprehensive nursing intervention in patients with multiple rib fractures with hemopneumothorax during thoracic cavity closed drainage (CTD) treatment.

A retrospective study was conducted in 42 patients with multiple rib fractures and hemopneumothorax (27 males and 15 females, average (45.32±5.43) years old) who were treated with CTD in People’s Hospital of Wulian County, Rizhao from January 2014 to October 2015 of clinical nursing information. On the basis of routine nursing, combined with comprehensive nursing interventions such as drainage tube nursing operation standard and strengthen the psychological care of patients, management of respiratory tract, pain nursing, diet nursing and prevention of complications, changes of patients with expectoration difficulty, pain severity, psychological status, the incidence of postoperative complications and patient satisfaction were observed.

Difficulty of expectoration after nursing intervention was significantly lower than that before intervention(P<0.05). After intervention, the scores of VAS, HAMA and HAMD scores of the patients were significantly lower than those of the control group: VAS: (3.12±0.41) scores vs (8.65±0.64) scores; HAMA: (22.34±4.69) scores vs (46.32±5.68); HAMA: (29.31±4.42) scores vs (47.43±6.82) scores, the difference was statistically significant (all P<0.05). The mean time of drainage tube retention was (66.78±1.59) h in 42 patients. No complications such as thoracic infection, subcutaneous emphysema and drainage tube were found during hospitalization. The total satisfaction of the patients was 100% (42/42).

Careful nursing intervention in patients with multiple rib fractures with hemopneumothorax can promote rehabilitation, improve prognosis and improve the quality of nursing care.