预防性护理对重症胰腺炎患者不良结局和脏器功能障碍的影响  

Effects of preventive nursing on the adverse outcomes and organ dysfunction in patients with severe acute pancreatitis

作　　者：王丽[1] 张露 陈琪 游丽 李艳丽[1] WANG Li;ZHANG Lu;CHEN Qi(Department of Critical Medicine,The First Affiliated Hospital of Chengdu Medical College,Sichuan,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院重症医学科,成都市610500

出　　处：《河北医药》2020年第10期1588-1591,共4页Hebei Medical Journal

摘　　要：目的探讨预防性护理对重症胰腺炎患者不良结局和脏器功能障碍的影响。方法选取2016年5月至2017年5月接收治疗的且采用常规护理方案的重症胰腺炎患者40例为A组,2017年6月至2018年6月接收的采用预防性护理方案的重症胰腺炎患者40例为B组,进行回顾性研究。观察2组患者不良事件发生情况;血清炎性因子和内毒素表达情况;护理前后器官功能障碍改善情况。结果A组患者感染率、脓毒血症发生率、手术率、腹泻率和误吸率均显著高于B组,差异有统计学意义(P<0.05)。2组患者治疗后白介素-1(IL-1)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)和内毒素水平均显著改善,但B组患者治疗后各指标均显著低于治A组,差异有统计学意义(P<0.05)。护理后呼吸系统、肾脏、肝脏、心血管、血液、神经系统和总评分均显著改善,且B组优于A组,差异有统计学意义(P<0.05)。结论预防性护理在重症胰腺炎患者中能够改善不良结局的发生率,降低患者炎症反应,改善器官功能障碍情况,值得推广。Objective To investigate the effects of preventive nursing on the adverse outcomes and organ dysfunction in patients with severe acute pancreatitis.Methods A total of 40 patients with severe pancreatitis who were admittd and treated by conventional nursing in our hospital from May 2016 to May 2017 were enrolled as group A,and the other 40 patients with severe pancreatitis who were admittd and treated by preventive nursing in our hospital from from June 2017 to June 2018 were enrolled as group B.The incidence of adverse events,the expression levels of serum inflammatory factors and endotoxin expression,and the improvement status of organ dysfunction before and after treatment were observed and compared between the two groups.Results The infection rate,the incidence rates of sepsis and diarrhea,the operative rate and aspiration rate in group A were significantly higher than those in group B(P<0.05).After treatment the levels of IL-1,IL-8,TNF-αand endotoxin were significantly improved in bot groups,moreover,which in group B were significantly lower than those in group A(P<0.05).After nursing,the scores of respiratory system,kidney,liver,cardiovascular,blood,nervous system and total scores were significantly improved in both groups,moreover,which in group B were superior to those in group A(P<0.05).Conclusion The preventive nursing can improve the incidence of adverse outcomes,reduce the inflammatory response and improve organ dysfunction in patients with severe pancreatitis.

关 键 词：预防性护理 重症胰腺炎 不良结局 脏器功能障碍 

分 类 号：R473.5[医药卫生—护理学]