层次化护理对急性非静脉曲张性上消化道出血患者BRS评分及护理满意度

Clinical effects of graded nursing in patients with acute non-varicose upper gastrointestinal bleeding

目的探讨层次化护理对急性非静脉曲张性上消化道出血患者布拉奇福德(Blatchford risk score,BRS)评分及护理满意度研究.方法选取2012-03/2015-06在建德市第一人民医院治疗的急性非静脉曲张性上消化道出血患者150例,随机分为干预组75例,对照组75例.对照组的患者仅进行常规护理,实验组患者除常规护理之外采取临床层次化护理干预措施.在护理5 wk后对两组患者护理前后的血尿素氮、血红蛋白、BRS评分进行比较分析,评价干预处理效果.结果干预组患者经临床层次化护理后血尿素氮、血红蛋白、BRS等指标均优于对照组,且对比差异具有统计学意义(P<0.05).对照组与干预组心率均值相比(96.33 bpm±5.89 bpm vs 97.54 bpm±5.45 bpm),差异并无统计学意义(P>0.05).干预组患者再出血率低于对照组(4.00%vs 14.67%),差异具有统计学意义(P<0.05).血尿素氮正常(3.3-6.4 mmol/L)患者共有14例(18.7%),异常的患者(>6.4 mmol/L)有61例(81.3%);75例对照组患者中血尿素氮含量正常7例(9.3%),异常68例(90.7%).经过?2检验,两组患者的差异并无明显差异(P>0.05).干预组患者的护理满意度、护理依从性指标均优于对照组,对比差异具有统计学意义(P<0.05).结论对急性非静脉曲张性上消化道出血患者进行层次化干预处理可以显著改善患者的临床状况,降低再出血几率,值得在临床上推广应用.

AIM To evaluate the clinical effects of graded nursing in patients with acute non-variceal upper gastrointestinal bleeding.METHODS From March 2012 to June 2015,150 patients with acute non-variceal upper gastrointestinal bleeding at our hospital were assigned to either an intervention group（n = 75） or a control group（n = 75）.Patients in the control group were given routine care alone,while patients in the experimental group was given routine care plus graded nursing intervention.Clinical parameters such as blood urea nitrogen,hemoglobin,and Blatchford risk score（BRS）at 5 wk after nursing care were compared between the two groups.RESULTS After nursing care,the levels of blood urea nitrogen,hemoglobin and BRS were significantly better in the experimental group than in the control group（P〈0.05）.Mean heart rate did not differ significantly between the two groups（P〈0.05）.The rebleeding rate was significantly lower in the experimental group than in the control group（4.00%vs 14.67%,P〉0.05）.The percentage of patients with normal blood urea nitrogen（3.3-6.4 mmol/ L） did not differ significantly between the experimental group and control group（18.7%vs 9.3%,P〈0.05）.The rate of patient＇s satisfaction and nursing compliance were significantly better in the experimental group than in the control group（P〈0.05）.CONCLUSION Graded nursing can significantly improve the clinical condition of patients and reduce rebleeding in patients with acute non-variceal upper gastrointestinal bleeding.