Study on the effect of comprehensive preoperative nursing intervention on airway injury after endotracheal intubation in patients undergoing video-assisted thoracoscopic lung surgery
综合性术前护理干预对胸腔镜下肺部手术患者气管插管后气道损伤的影响研究

摘要

目的 探讨综合性术前护理干预在降低胸腔镜下肺部手术患者气管插管后气道损伤发生率及严重程度方面的应用效果。方法 选取2025年1月至11月博白县人民医院收治的60例拟行择期胸腔镜下肺部手术的患者作为研究对象，根据不同护理方案将患者随机分为对照组（n=30）和干预组（n=30）。对照组给予常规术前护理，干预组在常规护理基础上给予综合性术前护理干预，包括结构化健康教育、呼吸功能优化训练、口腔护理、营养心理支持等。比较两组患者术后24h、48h气道损伤（以咽喉疼痛、声音嘶哑为主要观察指标）发生率与严重程度，同时对比术后首次下床活动时间、住院时间及护理满意度。结果 干预组患者术后24h、48h咽喉疼痛VAS评分为4.53±0.90分、2.10±0.80分，均显著低于对照组的6.27±1.14分、3.87±1.04分；干预组患者术后24h、术后48h声音嘶哑发生率分别为33.3%、16.7%，均显著低于对照组的76.7%、50.0%；干预组患者术后首次下床活动时间20.5±3.2h、术后住院时间5.8±1.2 d均显著短于对照组的26.8±4.1 h、7.5±1.6 d；干预组患者护理满意度评分为95.2±3.1分，显著高于对照组的88.6±4.5分；上述指标组间差异均有统计学意义（P＜0.05）。结论 对胸腔镜下肺部手术患者实施综合性术前护理干预，可有效降低气管插管后气道损伤程度、减少发生率，加速术后康复进程，提升护理服务质量与患者满意度，具有较高的临床推广价值。

Abstract

Objective To explore the application effect of comprehensive preoperative nursing intervention in reducing the incidence and severity of airway injury after endotracheal intubation in patients undergoing video-assisted thoracoscopic lung surgery.
Methods A total of 60 patients scheduled for elective Video-Assisted Thoracoscopic lung surgery admitted to Bobai County People's Hospital from January to November 2025 were selected as the research objects. They were randomly divided into the control group (n=30) and the intervention group (n=30) according to different nursing schemes. The control group received routine preoperative nursing, while the intervention group received comprehensive preoperative nursing intervention on the basis of routine nursing, including structured health education, optimized respiratory function training, oral care, nutritional and psychological support, etc. The incidence and severity of airway injury (with sore throat and hoarseness as the main observation indicators) at 24h and 48h after operation were compared between the two groups. Meanwhile, the time of first ambulation after operation, length of hospital stay and nursing satisfaction were compared.
Results The VAS scores of sore throat in the intervention group at 24h and 48h after operation were 4.53±0.90 and 2.10±0.80, which were significantly lower than those in the control group (6.27±1.14 and 3.87±1.04). The incidence rates of hoarseness in the intervention group at 24h and 48h were 33.3% and 16.7%, respectively, which were significantly lower than those in the control group (76.7% and 50.0%). The time of first ambulation after operation (20.5±3.2h) and length of hospital stay (5.8±1.2d) in the intervention group were significantly shorter than those in the control group (26.8±4.1h and 7.5±1.6d). The nursing satisfaction score of the intervention group was 95.2±3.1, which was significantly higher than that of the control group (88.6±4.5). All the above indicators showed statistically significant differences between the two groups (P<0.05).
Conclusion   Implementing comprehensive preoperative nursing intervention for patients undergoing Video-Assisted Thoracoscopic lung surgery can effectively reduce the degree and incidence of airway injury after endotracheal intubation, accelerate the postoperative rehabilitation process, improve the quality of nursing services and patient satisfaction, and has high clinical promotion value.