中医综合护理干预脓毒血症胃肠功能障碍临床研究
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R631+.1;R631+.2;R248

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Clinical Study on Comprehensive Nursing of Chinese Medicine for Gastrointestinal Dysfunction of Sepsis
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    摘要:

    目的:观察中医综合护理干预对严重脓毒血症胃肠功能障碍患者的治疗效果。方法:将脓毒血症胃肠功能障碍患者78例随机分为2组,对照组39例采用常规护理干预,观察组39例采用中医综合护理干预;观察比较2 组干预前后急性生理和慢性健康状况评分Ⅱ (APACHEⅡ) 评分、胃肠功能障碍评分、肠鸣音评分、腹腔压力、胃肠黏膜pH 值以及血浆D-乳酸水平;比较2 组干预后首次排便时间、肠鸣音恢复时间、胃潴留及死亡情况。结果:干预后,2组患者APACHEⅡ、胃肠功能障碍、肠鸣音评分均较干预前明显下降(P<0.05);且观察组上述各项评分均低于对照组(P<0.05)。干预后,2组患者腹腔压力、血浆D-乳酸水平均较干预前明显下降(P<0.05),胃肠黏膜pH 值明显升高(P<0.05);且观察组上述指标改善均较对照组更显著(P<0.05)。干预后,观察组首次排便时间、肠鸣音恢复时间短于对照组,胃潴留发生率、死亡率低于对照组,差异均有统计学意义(P<0.05)。结论:中医综合护理干预用于脓毒血症胃肠功能障碍患者效果显著,可有效改善患者胃肠道功能,促进肠屏障功能恢复,减少胃潴留的发生,降低死亡率。

    Abstract:

    Abstract: Objective: To observe the clinical effect of comprehensive nursing of Chinese medicine for patients with gastrointestinal dysfunction of severe sepsis. Methods: A total of 78 cases of patients with gastrointestinal dysfunction of severe sepsis were randomly divided into two groups,39 cases in each group. The control group was given routine nursing, and the observation group was given comprehensive nursing of Chinese medicine. Before and after intervention,the scores of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), gastrointestinal dysfunction and bowel sounds, the abdominal pressure,the pH values of gastrointestinal mucosa and the levels of D-lactate in plasma in the two groups were observed and compared. After intervention, the first defecation time, the recovery time of bowel sounds, the gastric retention and the mortality in the two groups were compared. Results: After intervention, the scores of APACHE Ⅱ , gastrointestinal dysfunction and bowel sounds in the two groups were significantly decreased when compared with those before intervention(P<0.05);the above scores in the observation group were lower than those in the control group(P<0.05). After intervention, the abdominal pressure and the levels of D- lactate in plasma in the two groups were significantly decreased when compared with those before intervention(P<0.05), and the pH value of gastrointestinal mucosa was significantly increased(P<0.05);the improvement of the above indexes in the observation group was more significant than that in the control group(P<0.05). After intervention,the first defecation time and the recovery time of bowel sounds in the observation group were shorter than those in the control group,and the incidence of gastric retention and the mortality were lower,differences being significant(P<0.05). Conclusion:The intervention of comprehensive nursing of Chinese medicine hassignificant effect in treatingpatients with gastrointestinal dysfunction of sepsis, which can effectively improve gastrointestinal function,promote the recovery of gut barrier and reduceincidence of gastric retention and mortality.

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邱淑兰,毛一清,朱根英.中医综合护理干预脓毒血症胃肠功能障碍临床研究[J].新中医,2020,52(12):203-205

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  • 在线发布日期: 2020-06-15
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