循证护理在重症吉兰-巴雷综合征机械通气患者早期肠内营养支持中的应用

The application of evidence- based nursing in assessing early enteral nutrition in severe Gulillain- Barre syndrome patients

目的：探讨循证护理在重症吉兰-巴雷（GBS）机械通气患者早期肠内营养（EN）支持中的作用。方法：将2009年1月~2011年12月我院神经内科收治的24例重症GBS机械通气早期EN患者设为对照组,对其临床资料进行回顾性分析,归纳影响早期EN疗效及引起相关并发症的原因;将2012年1月~2013年12月收治的24例重症GBS机械通气早期EN患者设为观察组,采取循证护理,针对早期肠内营养6个关键环节进行循证,制定流程及规范性操作等护理干预。比较两组患者营养支持前后各项营养指标及相关并发症指标。结果：治疗7,14 d后,观察组血清白蛋白（Alb）、血清前白蛋白（PA）、血红蛋白（Hb）等营养学指标优于对照组（P〈0.05）,肺部感染、反流、腹泻等并发症发生率低于对照组,机械通气天数少于对照组（P〈0.05）。结论：将循证护理方法应用于重症GBS机械通气早期EN患者,能够改善营养状况,缩短机械通气时间,有效减少肠内营养支持导致的并发症,提高救治成功率。

Objective： To explore the value of evidence- based nursing in assessing enteral nutrition（ EN） in severe Gulillain- Barre syndrome（ GBS） patients. Methods： A retrospective study was performed on 24 patients with GBS from January 2009 to December 2011 to analyze the effect of EN and the cause of complications. These 24 GBS patients were set as the control group. Severe GBS patients be hospitalized from January 2012 to December 2013 undergoing evidence- based nursing were set as observation group. Six key areas of early EN were observed,processes and regulatory operations were performed,and nursing intervention were done in these patients. The indicators and complications were compared between two groups of patients. Results： Alb,PA and Hb of patients in observation group were significantly increased after treatment for 7 days and 14 days（ all P〈0. 05）. The occurrence of were significantly decreased in patients of observation group（ all P〈0. 05）. Conclusion： Evidence- based nursing could improve nutritional status,shorten duration of mechanical ventilation,reduce complications caused by enteral nutrition,and improve treatment success rate when performed in GBS patients.