严重腹部创伤患者损伤控制复苏护理方案的构建

doi:10.3761/j.issn.0254-1769.2020.12.002

中华护理杂志 ›› 2020, Vol. 55 ›› Issue (12): 1770-1776.DOI: 10.3761/j.issn.0254-1769.2020.12.002

严重腹部创伤患者损伤控制复苏护理方案的构建

刘峰(),叶向红,丁威威,黄萍,刘宝晨,韩小琴,吴翠丽,孙琳()

233030安徽省蚌埠市蚌埠医学院研究生院(刘峰);东部战区总医院全军普通外科研究所(叶向红,丁威威,刘宝晨,吴翠丽),急救医学科(韩小琴),军队伤病员管理科(孙琳);南京大学医学院附属鼓楼医院急诊科(黄萍)

收稿日期:2020-02-23 出版日期:2020-12-15 发布日期:2020-12-08
通讯作者: 孙琳
作者简介:刘峰:女,硕士,护士, E-mail:liufeng10229901@163.com
基金资助:
全军医学科技青年培育计划护理项目(19QNP077)

Construction of nursing of damage control resuscitation for patients with severe abdominal trauma：a Delphi study

LIU Feng(),YE Xianghong,DING Weiwei,HUANG Ping,LIU Baochen,HAN Xiaoqin,WU Cuili,SUN Lin()

Bengbu Medical College,School of Nursing,Bengbu,233030,China

Received:2020-02-23 Online:2020-12-15 Published:2020-12-08
Contact: Lin SUN

摘要/Abstract

摘要：

目的基于损伤控制复苏理念,构建严重腹部创伤患者损伤控制复苏护理方案。方法通过文献回顾、临床观察及头脑风暴等方法,整合腹部创伤相关指南和文献,制订护理方案初稿,经德尔菲法专家函询,确定严重腹部创伤患者损伤控制复苏护理方案。结果 2轮专家函询中,专家积极系数分别为88.89%、100%,专家权威系数均为0.88,2轮函询条目的肯德尔和谐系数分别为0.29、0.32,最终形成的护理方案包括2项一级条目,15项二级条目,50项三级条目。结论本研究构建的护理方案具有科学性、可靠性及适用性,可为临床创伤护理提供指导。

关键词: 腹部损伤, 损伤控制复苏, 创伤护理, 护理实践

Abstract:

Objective To construct a nursing plan for damage control resuscitation in patients with severe abdominal trauma based on the concept of damage control resuscitation. Methods Based on literature reviews,clinical structure observation and expert meetings,the guidelines and literature related to abdominal trauma were integrated,and the first draft of the nursing plan was formulated. After Delphi expert consultations,the practice plan of damage control resuscitation for patients with severe abdominal trauma was determined. Results In the 2 rounds of expert consultations,the expert positive coefficients were 88.89% and 100%,and the expert authority coefficients were 0.88. The coordination coefficients of items in 2 rounds of inquiry were 0.29 and 0.32,respectively. The final practice plan includes 2 first-level items,15 second-level items,and 50 third-level items. Conclusion The nursing plan constructed in this study is scientific,reliable and practical,and provides guidance for clinical trauma care.

Key words: Abdominal Injuries, Damage Control Resuscitation, Trauma Care, Nursing Practice

刘峰,叶向红,丁威威,黄萍,刘宝晨,韩小琴,吴翠丽,孙琳. 严重腹部创伤患者损伤控制复苏护理方案的构建[J]. 中华护理杂志, 2020, 55(12): 1770-1776.

LIU Feng,YE Xianghong,DING Weiwei,HUANG Ping,LIU Baochen,HAN Xiaoqin,WU Cuili,SUN Lin. Construction of nursing of damage control resuscitation for patients with severe abdominal trauma：a Delphi study[J]. Chinese Journal of Nursing, 2020, 55(12): 1770-1776.

图/表 1

参考文献 22

[1]	赵泽文, 胡清华, 张孝才, 等. 损伤控制外科理念在高原严重腹部创伤中的应用研究[J]. 重庆医学, 2018,47(35):4497-4499,4503.
	Zhao ZW, Hu QH, Zhang XC, et al. Study on application of damage control surgery concept in plateau severe abdominal trauma[J]. Chongqing Med, 2018,47(35):4497-4499,4503.
[2]	MacKenzie EJ, Rivara FP, Jurkovich GJ, et al. A national evaluation of the effect of trauma-center care on mortality[J]. N Engl J Med, 2006,354(4):366-378. DOI URL PMID
[3]	刘超. 以腹部创伤为主的严重多发伤的救治[D]. 蚌埠:蚌埠医学院, 2014.
	Liu C. The treatment of abdominal injury with severe multiple trauma[D]. Bengbu:Bengbu Medical College, 2014.
[4]	周建林. 浅析损伤控制复苏在严重腹部创伤院前急救中的应用[J]. 浙江创伤外科, 2018,23(1):135-136.
	Zhou JL. Analysis of damage control resuscitation in prehospital emergency care for severe abdominal trauma[J]. Zhejiang J Trauma Surg, 2018,23(1):135-136.
[5]	沈丛林, 姜丽娟, 龚辉. 损伤控制性手术在严重腹部创伤急救中的临床应用分析[J]. 海军医学杂志, 2017,38(5):464-465.
	Shen CL, Jiang LJ, Gong H. Analysis of the clinical application of damage control surgery in emergency treatment of severe abdominal trauma[J]. J Navy Med, 2017,38(5):464-465.
[6]	Holcomb JB, Jenkins D, Rhee P, et al. Damage control resuscitation:directly addressing the early coagulopathy of trauma[J]. J Trauma, 2007,62(2):307-310. DOI URL PMID
[7]	刘建文, 洪学映, 郑兴武, 等. 损伤控制外科技术在急诊外科多发伤救治中的应用效果观察[J]. 中国医药科学, 2019,9(17):189-191.
	Liu JW, Hong XY, Zheng XW, et al. Observation on the application effect of injury control surgical technique in treatment of multiple trauma in emergency surgery department[J]. China Med Pharm, 2019,9(17):189-191.
[8]	孙琳, 于丹, 韩小琴, 等. 对急诊科护士损伤控制性复苏相关知识的调查分析[J]. 中华现代护理杂志, 2018,24(28):3394-3396.
	Sun L, Yu D, Han XQ, et al. Survey of damage control resuscitation related knowledge in emergency service nurses[J]. Chin J Mod Nurs, 2018,24(28):3394-3396.
[9]	Wijesuriya JD, Keogh S. Integrated major haemorrhage management in the retrieval setting:damage control resuscitation from referral to receiving facility[J]. Emerg Med Australas, 2017,29(4):470-475. DOI URL PMID
[10]	黎燕清, 李慧敏, 王艳丽, 等. 19例严重腹部损伤控制性手术患者重症监护室的护理[J]. 中华护理杂志, 2008,43(5):417-419.
	Li YQ, Li HM, Wang YL, et al. Nursing care of 19 patients with severe abdominal trauma undergoing damage control surgery[J]. Chin J Nurs, 2008,43(5):417-419.
[11]	Palmer CS, Gabbe BJ, Cameron PA. Defining major trauma using the 2008 Abbreviated Injury Scale[J]. Injury, 2016,47(1):109-115. URL PMID
[12]	朱爽, 赵文静, 卢天舒, 等. 灾害辅助救援人员快速培训方案的构建[J]. 中华护理杂志, 2018,53(2):230-233.
	Zhu S, Zhao WJ, Lu TS, et al. Construction of rapid training program for post-disaster auxiliary rescue personnel within restricted area[J]. Chin J Nurs, 2018,53(2):230-233.
[13]	赵泽华, 孙琳, 刘云, 等. 急诊创伤患者低体温管理方案的构建[J]. 中华护理杂志, 2018,53(4):448-453.
	Zhao ZH, Sun L, Liu Y, et al. Study on establishing management programs for hypothermia in trauma patients in emergency department[J]. Chin J Nurs, 2018,53(4):448-453.
[14]	Marciniuk P, Pawlaczyk R, Rogowski J, et al. REBOA-new era of bleeding control,literature review[J]. Pol Przegl Chir, 2019, 92(5):1-5. DOI URL PMID
[15]	王强, 张伟. 腹部创伤的诊疗进展[J]. 创伤外科杂志, 2019,21(10):721-724.
	Wang Q, Zhang W. Diagnosis and treatment of abdominal trauma[J]. J Trauma Surg, 2019,21(10):721-724.
[16]	Fitzpatrick ER. Open abdomen in trauma and critical care[J]. Crit Care Nurse, 2017,37(5):22-45. URL PMID
[17]	黎介寿. 损伤控制性外科技术手册[M]. 北京: 人民军医出版社, 2009: 3-4.
	Li JS. Handbook of Damage Control Surgery Techniques[M]. Beijing: People's Army Medical Press, 2009: 3-4.
[18]	Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma:fifth edition[J]. Crit Care, 2019,23:98. URL PMID
[19]	Borgman MA, Spinella PC, Perkins JG, et al. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital[J]. J Trauma, 2007,63(4):805-813. DOI URL PMID
[20]	Germanos S, Gourgiotis S, Villias C, et al. Damage control surgery in the abdomen:an approach for the management of severe injured patients[J]. Int J Surg, 2008,6(3):246-252. DOI URL
[21]	Duchesne JC, McSwain NE Jr, Cotton BA, et al. Damage control resuscitation:the new face of damage control[J]. J Trauma, 2010,69(4):976-990. URL PMID
[22]	Cannon JW, Khan MA, Raja AS, et al. Damage control resuscitation in patients with severe traumatic hemorrhage:a practice management guideline from the Eastern Association for the Surgery of Trauma[J]. J Trauma Acute Care Surg, 2017,82(3):605-617. URL PMID

严重腹部创伤患者损伤控制复苏护理方案的构建

Construction of nursing of damage control resuscitation for patients with severe abdominal trauma：a Delphi study

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 1

参考文献 22

相关文章 12

编辑推荐

Metrics

[1]	马玉霞,张园园,王玉坦,李思君,燕芳红,韩琳. 临床护理分类系统在护理实践中的应用进展及启示[J]. 中华护理杂志, 2021, 56(1): 132-136.
[2]	成人失禁相关性皮炎护理实践专家共识组. 成人失禁相关性皮炎护理实践专家共识[J]. 中华护理杂志, 2020, 55(supplement): 100-105.
[3]	莫圆圆, 李惠玲, 田利, 眭文洁, 孟红燕, 李春会, 景秀琛. 高级护理实践工作坊的建立及实践[J]. 中华护理杂志, 2020, 55(6): 911-914.
[4]	刘文驰, 赵旭, 张淑芳, 张振美, 王俊巧, 杨丽娟. 原发性血小板增多症患者下肢皮肤顽固性溃疡的循证护理实践[J]. 中华护理杂志, 2020, 55(2): 266-271.
[5]	贾磊,王茵. 美国高级助产护士的发展现状及启示[J]. 中华护理杂志, 2020, 55(11): 1740-1744.
[6]	刘春香, 成传芳, 赵晨, 翟洁婷, 刘春兰, 段功香. 骨折联络服务在老年髋部脆性骨折患者中的应用[J]. 中华护理杂志, 2019, 54(9): 1343-1348.
[7]	马冬飞, 孙皎, 赵英男, 万真真, 孙丹, 李焕焕, 邢庄婕, 李媛, 金花. 痴呆患者精神行为症状相关护理模式的研究进展[J]. 中华护理杂志, 2019, 54(7): 1017-1022.
[8]	张秀英李秀华蒋红赵瑾李芸徐雲. 国际联合委员会评审对护理实践的影响研究[J]. 中华护理杂志, 2018, 53(3): 342-345.
[9]	李晶高尚谦邓俊王兰刘霞丁炎明. 循证转化护理专业组的建立及实践[J]. 中华护理杂志, 2017, 52(12): 1505-1508.
[10]	李睿文席淑新. 耳鼻咽喉科高级实践护士培养的研究进展[J]. 中华护理杂志, 2017, 52(12): 1516-1519.
[11]	薛阳阳施天奇吴翠丽叶向红丁威威彭南海. 1 例严重腹部外伤致肠空气瘘患者行二次腹壁植皮术的护理[J]. 中华护理杂志, 2017, 52(1): 80-83.
[12]	李肖静史云菊. 护士实践量表的汉化及信效度检验[J]. 中华护理杂志, 2016, 51(8): 1009-1011.