集束化中医护理措施对脓毒症胃肠功能障碍的改善作用  

作　　者：卢强芳 江荣林[1] 王兰芳[1] 阮龙娟[1] 郑春美[1] 徐琦琦 

机构地区：[1]浙江中医药大学附属第一医院,310006

出　　处：《浙江临床医学》2021年第3期435-436,438,共3页Zhejiang Clinical Medical Journal

基　　金：国家自然科学基金资助项目(81774070);浙江省中医药防治重大疾病攻关计划项目(2012ZGG001)。

摘　　要：目的观察集束化中医护理措施对脓毒症继发胃肠功能障碍的临床效果。方法脓毒症继发胃肠功能障碍患者120例,根据纳入、排除和脱落标准共入组95例,按照随机数字表法分为对照组(46例)与观察组(49例)。对照组给予常规护理,观察组在对照组基础上加用集束化中医护理措施,包括辨证施治的中药灌胃和灌肠、芒硝敷脐、新斯的明足三里穴位注射、耳穴压豆,比较两组的胃肠功能障碍的改善情况及临床预后。结果干预后第7天,观察组胃肠功能障碍评分(GIF)、腹内压、腹围、急性生理与慢性健康状况I评分(APACHEI)比对照组降低、肠呜音增加(均P<0.05)。且观察组首次排便时间和住ICU时间短于对照组、28 d病死率降低,差异均有统计学意义(P<0.05)。结论集束化中医护理措施能促进脓毒症患者胃肠功能障碍的恢复,改善临床预后。Objective To observe the clinical effect of bundle nursing measures of traditional Chinese Medicine(TCM)on patients with gastrointestinal failure secondary to sepsis.Methods 120 patients with gastrointestinal failure secondary to sepsis were divided into control group(46 cases)and observation group(49 cases)according to the criteria of inclusion,exclusion and abscission.The control group was given routine nursing care,and the observation group was given bundle TCM nursing care measures on the basis of the control group,including TCM gavage and enema based on syndrome differentiation,mirabilite navel application,Zusanli point injection with neostigmine and auricular acupoint pressing bean,the improvement and clinical prognosis of gastrointestinal failure were compared between the two groups.Results On the 7th day after intervention,the gastrointestinal failure score(GIF),intra-abdominal pressure(IAP),abdominal circumference,acute physiological and chronic health condition II score(Apache II)in the observation group were lower than those in the control group,and the bowel sounds were increased(P<0.05).The first defecation time and stay in ICU in the observation group were shorter than those in the control group,and the 28-day mortality was lower than that in the Control Group(P<0.05).Conclusion The bundle nursing measures of TCM can promote the recovery of gastrointestinal failure in patients with sepsis and improve the clinical prognosis.

关 键 词：脓毒症 胃肠功能障碍 集束化 中医护理 

分 类 号：R47[医药卫生—护理学]