急性重症胰腺炎的临床护理路径建立及其效果

Clinical effects of clinical nursing pathway for acute pancreatitis

目的探讨临床护理路径的实施对急性重症胰腺炎(severe acute pancreatitis,SAP)患者康复效果的影像.方法选择2015-01/2016-12于银川市第二人民医院消化内科治疗的SAP非手术患者为研究对象,将研究对象随机分为观察组与对照组,两组各80例.观察组与对照组分别施以临床路径为指导的护理与常规护理,观测患者腹部症状的持续时间、住院时间、并发症的发生及患者对护理工作的满意度.结果观察组与对照组患者腹胀时间分别为6.02 d±4.23 d、8.56 d±5.33 d,腹胀的持续时间分别为6.78 d±4.21 d、9.67 d±5.92 d,观察组腹痛与腹胀时间均低于对照组(t=3.308,P=0.001;t=3.558,P<0.001).观察组与对照组的住院时间分别为27.50 d±9.32 d、34.45d±12.72 d,观察组住院时间明显低于对照组(t=3.942,P<0.001).观察组与对照组并发症累计发生例次数为8与44,观察组与对照鼻、食管黏膜损伤(X^2=5.77,P=0.017),压疮(X^2=4.33,P=0.023),下肢静脉血栓(X^2=5.38,P=0.021)与肺部感染(X^2=10.03,P<0.001)发生率均低于对照组.观察组平均满意度得分为24.7分±3.9分,对照组平均得分为21.2分±4.3分,观察组平均得分高于对照组(t=5.39,P<0.001).结论对SAP患者采用以临床护理路径的干预措施,能有效促进患者康复,能减少患者治疗过程中的并发症的发生,减少患者负面情绪,促进患者康复.

AIM To evaluate the effect of clinical nursing pathway for acute pancreatitis（AP）.METHODS One hundred and sixty patients with AP treated at our hospital from January 2015 to December 2016 were enrolled in this study.The patients were randomly divided into either an observation group or a control group,with 80 cases in each group.Clinical nursing pathway was used in the observation group,while conventional nursing care was used in the control group.Clinical symptoms,length of hospital stay,and adverse effects were compared between the two groups.RESULTS The duration of stomach ache and abdominal distention was significantly shorter in the observation group than in the control group（6.02 d±4.23 d vs 8.56 d±5.33 d,t = 3.308,P =0.001;6.78 d±4.21 d vs 9.67 d±5.92 d,t = 3.558,P 〈 0.001）.The length of hospital stay was significantly shorter in the observation group than in the control group（27.50 d±9.32 d vs34.45 d±12.72 d,t= 3.942,P 〈 0.001）.The rate of adverse effects such as esophageal mucosal injury,lower limb vein thrombosis,and lung infection was significantly lower in the observation group than in the control group.CONCLUSION Clinical nursing pathway can promote the rehabilitation of AP and reduce adverse effect and negative emotion.