The effect of programmed emergency nursing in patients of pulmonary tuberculosis with massive hemoptysis

doi:10.19982/j.issn.1000-6621.20230053

Abstract

Abstract:

Objective: To explore the effect of programmed emergency nursing in patients with pulmonary tuberculosis massive hemoptysis. Methods: From January 1, 2019 to December 31, 2020, 163 patients with pulmonary tuberculosis and massive hemoptysis were selected from the Tuberculosis Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine. Eighty-one patients admitted between January 1, 2019 and December 31, 2019 were included in the conventional group and 82 patients admitted between January 1, 2020 and December 31, 2020 were included in the programmed group. Regular nursing care methods were used in the conventional group, and programmed emergency nursing procedures were applied in the programmed group. The preparation time for bronchial artery embolization, hospital stay, hospital cost, disease-related critical complications, incidence of complications after bronchial artery embolization and patient satisfaction were compared between two groups. Results: The preparation time of bronchial artery embolization, hospital stay, and hospital cost were (43.28±11.54) min, (15.22±3.58) d, and (64.4±10.1) RMB thousand yuan in the conventional group and (25.90±6.21) min, (10.11±2.58) d, and (47.8±8.7) RMB thousand yuan in the programmed group, respectively. All of them were significantly lower in the programmed group than in the conventional group, and the differences were statistically significant (t=-11.993, -10.464, -11.247, all P<0.001); the postoperative complication rate of bronchial artery embolization was higher in the conventional group (25.93%, 21/81) than in the programmed group (12.20%, 10/82), and the difference was statistically significant (χ²=4.988,P=0.026); the incidence of severe complications including apnea and shock was higher in the conventional group (13.58%, 11/81) than in the programmed group (3.66%, 3/82), with a statistically significant difference (χ²=5.109,P=0.024); patient satisfaction was higher in the programmed group (98.78%, 81/82) than in the conventional group (91.36%, 74/81), but the difference was not statistically significant (χ²=3.351,P=0.067). Conclusion: Programmed emergency nursing could shorten the rescue time and the hospitalization time of patients with pulmonary tuberculosis massive hemoptysis, reduce the hospitalization cost and the incidence of complications, and improve the satisfaction of patients with pulmonary tuberculosis massive hemoptysis.

Key words: Tuberculosis, Hemoptysis, Postoperative complications, Emergency medical services, Nursing care

CLC Number:

R521

Huang Jinpeng, Chen Yuanyuan, Gao Dan, Mao Xiaoxiao, Zhang Yue, Gao Jing. The effect of programmed emergency nursing in patients of pulmonary tuberculosis with massive hemoptysis[J]. Chinese Journal of Antituberculosis, 2023, 45(8): 768-774. doi: 10.19982/j.issn.1000-6621.20230053

Figures/Tables 6

指标	常规组(81例)	程序化组(82例)	统计检验值	P值
性别[例,构成比(%)]			χ²=0.149	0.699
男性	52(64.20)	55(67.07)
女性	29(35.80)	27(32.93)
年龄(岁, $x ˉ$ ±s)	49.30±5.50	48.00±4.50	t=1.652	0.100
BMI[M(Q₁,Q₃)]	19.82(17.53,23.00)	21.63(18.51,23.94)	Z=-1.848	0.065
收缩压[mmHg,M(Q₁,Q₃)]	123.00(118.50,129.50)	123.00(120.00,128.00)	Z=-0.928	0.353
舒张压[mmHg,M(Q₁,Q₃)]	73.00(66.00,84.50)	75.00(70.00,82.00)	Z=-0.668	0.504
心率[次/min,M(Q₁,Q₃)]	85.00(79.00,89.00)	83.00(79.00,89.00)	Z=-0.574	0.566
休克指数[M(Q₁,Q₃)]	70.83(63.66,70.83)	65.96(62.94,71.02)	Z=-1.712	0.087
血小板[×10⁹/L,M(Q₁,Q₃)]	198.00(154.00,249.50)	203.00(163.00,241.00)	Z=-0.516	0.606
WBC[×10⁹/L,M(Q₁,Q₃)]	6.50(5.30,8.15)	6.40(5.00,8.35)	Z=-0.174	0.862
Hb[g/L,M(Q₁,Q₃)]	118.00(107.00,129.00)	122.00(111.00,141.00)	Z=-1.585	0.113
白蛋白[g/L,M(Q₁,Q₃)]	36.20(33.40,39.50)	37.20(33.20,40.00)	Z=-0.640	0.522
CRP[mg/L,M(Q₁,Q₃)]	14.54(3.26,37.98)	12.00(2.22,31.55)	Z=-1.129	0.259
D-二聚体[g/L,M(Q₁,Q₃)]	500.00(270.00,1065.00)	470.00(260.00,920.00)	Z=-0.387	0.699
红细胞压积[%,M(Q₁,Q₃)]	35.70(31.50,39.65)	36.30(32.35,41.65)	Z=-0.982	0.326
并发症[例,发生率(%)]			χ²=0.894	0.925
肺曲霉菌	10(12.35)	8(9.76)
空洞	31(38.27)	32(39.02)
毁损肺	4(4.94)	6(7.32)
糖尿病	26(32.10)	24(29.27)
高血压	10(12.35)	12(14.63)
痰菌[例,构成比(%)]			χ²=0.050	0.822
阴性	47(58.02)	49(59.76)
阳性	34(41.98)	33(40.24)

指标	常规组(81例)	程序化组(82例)	t值	P值
支气管动脉栓塞术前准备时间(min, $x ˉ$ ±s)	43.28±11.54	25.90±6.21	-11.993	<0.001
住院时间(d, $x ˉ$ ±s)	15.22±3.58	10.11±2.58	-10.464	<0.001
住院费用(万元, $x ˉ$ ±s)	6.44±1.01	4.78±0.87	-11.247	<0.001

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并发症	常规组(81例)	程序化组(82例)	χ²值	P值
发热	15(18.52)	10(12.20)	1.255	0.263
胸部疼痛	12(14.81)	6(7.32)	2.332	0.127
穿刺处血肿	7(8.64)	3(3.66)	0.998	0.318
尿潴留	10(12.35)	5(6.10)	1.904	0.168
合计	21(25.93)	10(12.20)	4.988	0.026

危重并发症	常规组(81例)	程序化组(82例)	χ²值	P值
窒息	7(8.64)	2(2.44)	1.934	0.164
休克	4(4.94)	1(1.22)	0.851	0.356
合计	11(13.58)	3(3.66)	5.109	0.024

满意度	常规组(81例)	程序化组(82例)	χ²值	P值
非常满意	60(74.07)	70(85.37)	3.218	0.073
一般满意	14(17.28)	11(13.41)	0.470	0.493
不满意	7(8.64)	1(1.22)	3.351	0.067
总满意度	74(91.36)	81(98.78)	3.351	0.067