焦点解决模式在脓毒症合并急性肾损伤患者中的护理效果

The effect of focus resolution mode in patients with sepsis combined with acute renal injury

目的探讨焦点解决模式在脓毒症合并急性肾损伤患者中的护理效果。方法选择2015月5月～2017年5月哈尔滨医科大学附属第一医院重症医学科收治的脓毒症合并急性肾损伤患者90例作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各45例。对照组给予常规护理干预,观察组在对照组基础上给予焦点解决模式。比较干预前后两组实验室临床指标,采用匹兹堡睡眠质量指数量表(PSQI)对干预前后两组患者的睡眠质量进行评价,采用自制的舒适度问卷对干预后两组患者的舒适度进行比较。结果两组住院期间采用机械通气率、肺损伤率、体温、白细胞水平、凝血酶原时间比较,差异无统计学意义(P>0.05),但观察组合并休克发生率、乳酸水平、查尔森基础疾病权重指数低于对照组,平均动脉压水平、基础肾小球滤过率明显高于对照组,差异均有统计学意义(P<0.05)。干预前两组PSQI量表各项目评分和舒适度评分比较,差异无统计学意义(P>0.05);干预后两组上述评分均明显低于干预前,观察组上述评分均明显低于对照组,差异均有统计学意义(P<0.05)。结论焦点解决模式可有效缓解脓毒症合并急性肾损伤患者的临床不适,改善其睡眠质量,促进其日常舒适度的提高,对于改善患者的预后生活质量具有重要作用,值得临床推广应用。

Objective To explore the effect of focus resolution mode in patients with sepsis combined with acute renal injury. Methods A total of 90 patients with sepsis combined with acute renal injury in Department of Intensive Care Unit, the First Affiliated Hospital of Harbin Medical University from May 2015 to May 2017 were selected as the research objects and divided into the control group and the observation group by random number table, with 45 cases in each group. The control group was given routine nursing intervention, while the observation group was given focus resolution mode on the basis of control group. The clinical indicators in the two groups were compared before and after the intervention. The Pittsburgh sleep quality index（PSQI） was used to evaluate the sleep quality of patients in both groups before and after intervention. The self-designed comfort questionnaire was used to compare the comfort of patients in the two groups after intervention. Results There were no statistically significant differences between the two groups in the incidence of mechanical ventilation during hospitalization and lung injury, body temperature, leukocyte level, prothrombin time（P〈0.05）. The incidence of shock, lactic acid level, Charleson＇s basic disease weight index in the observation group were lower than those of control group; the mean arterial pressure and basal glomerular filtration rate were significantly higher than those of control group, with statistically significant differences（P〈0.05）. Before intervention, there were no statistically significant differences in the scores of PSQI of each item and comfort between the two groups（P〈0.05）; after intervention, the scores above in the two groups were all significantly lower than those of before intervention and the scores above in the observation group were significantly lower than those of control group,with statistically significant differences（P〈0.05）. Conclusion Focus resolution mode can effectively relieve the clinical discomfort of patients with sepsis combined with acute kidney injury, improve the sleep quality, promote the daily comfort of the patients. It plays an important role in improving the prognosis and life quality of the patients. It is worthy of promotion and application.