老年患者急性胃穿孔的护理

目的探讨护理干预对老年急性胃穿孔患者手术效果和预后的影响,为临床护理工作提供参考。方法选择2008年3月～2010年12月收治的急性胃穿孔老年患者36例,均于急诊行胃大部切除术或胃修补术,围手术期给予系统的护理干预。观察护理干预对手术效果和预后的影响,比较治疗前后患者血清胃泌素(GAS)水平的变化。结果全部患者均顺利完成手术,术后胃肠功能恢复良好。患者术后发生并发症3例,发生率为8.33%,均经对症治疗后痊愈,无一例发生死亡。与术前比较,术后12、24、48h血清胃泌素水平明显较高,差异有统计学意义(P<0.05)。随访6个月,患者均恢复正常生活。结论系统的护理干预对老年患者急性胃穿孔有促进康复、保证手术成功、改善预后的积极作用,效果较好。

Objective To explore the nursing intervention on elderly patients with acute gastric perforation operation effect and prognostic implications for clinical nursing work, provide a reference. Methods In our hospital from 2008 March to 2010 December were acute gastric perforation in 36 cases of elderly patients, both in emergency subtotal gastrectomy or gastric repair, perioperative period nursing intervention for system operation. Observation on effect of nursing intervention on operation effect and prognosis, compare before and after treatment in patients with serum gastrin （GAS） level changes. Results All patients were successfully completed operation, postoperative recovery of gastrointestinal function well. Patients with postoperative complications occurred in 3 cases, the incidence was 8.33%, by symptomatic treatment cured, no case of death. Compared with the preoperative, postoperative 12h, 24h, 48h serum gastrin levels were significantly higher, the difference was statistically significant （P〈0.05）. A follow-up of 6 months, all patients resumed a normal life. Conclusion The nursing intervention on elderly patients with acute perforation of stomach to promote rehabilitation, to guarantee the successful operation, improve the prognosis of the positive role, is worth the clinical application.