循证护理在经皮内镜下胃造瘘术术后肠内营养支持中的应用效果

Application Effect of Evidence-based Nursing in the Enteral Nutrition Support after the Percutaneous Endoscopic Gastrotomy

目的探讨循证护理在经皮内镜下胃造瘘术术后肠内营养支持中的应用效果。方法 120例患者均为2016年3月—2017年2月期间在该院接受经皮内镜下胃造瘘术的病例,随机将其分为观察组和观察组,每组60例。对照组患者接受围手术期常规护理措施,观察组患者接受循证护理。观察两组患者术后营养输注方式和皮肤敷料更换频率,并就两组患者术后各项并发症的发生率。同时,随访3个月,采用生活质量评分(SF-36)评价两组患者治疗前后生活质量改善情况。结果观察组患者间歇滴注18例,持续泵入42例,对照组患者间歇滴注28例,持续泵入32例,观察组患者敷料更换频率1次/d的有14例,1次/3 d的有46例,与对照组24例、36例的比例比较差异有统计学意义(P<0.05)。术后统计得出,观察组患者总计4例发生并发症显著低于对照组10例,差异有统计学意义(P<0.05)。观察组患者治疗后SF-36评分为(82.4±11.0)分较治疗前(70.2±6.6)分有显著改善,且优于对照组治疗后(74.6±8.0)分,差异有统计学意义(P<0.05)。结论循证护理对于经皮内镜下胃造瘘术患者术后肠内营养支持有较好的应用价值,在保证手术疗效的同时,预防相关并发症的发生,促进患者胃肠功能,有利于早期恢复。

Objective To study the application effect of evidence-based nursing in the enteral nutrition support after the percutaneous endoscopic gastrotomy.Methods 120 cases of patients with percutaneous endoscopic gastrotomy in our hospital from March 2016 to February 2017 were selected and randomly divided into two groups with 60 cases in each,the control group adopted the routine nursing measures during the preoperative period,while the observation group adopted the evidence-based nursing.The postoperative nutrition infusion method,skin dressing change frequency and incidence rates of various complications after surgery of the two groups were observed,at the same time,the improvement situation of quality of life before and after treatment of the two groups was evaluated by the SF-36 score by the 3 month follow-up.Results In the observation group,there were 18 cases with intermittent drip and 42 cases with continuous pumping,and in the control group,there were 28 cases with intermittent drip and 32 cases with continuous pumping,and in the observation group,there were 14 cases whose dressing change frequency was 1/d and 46 cases was 1/3 d,in the control group,the numbers were respectively 24 cases and 36 cases,and the differences were statistically significant(P<0.05).The incidence rate of complications in the observation group was obviously lower than that in the control group,(4 cases vs 10 cases),and the difference was statistically significant(P<0.05);the SF-36 score after treatment in the observation group was obviously improved compared with that before treatment[(82.4±11.0)points vs(70.2±6.6)points],and the index was better than that in the control group after treatment,which was(74.6±8.0)points,and the difference was statistically significant(P<0.05).Conclusion The evidence-based nursing has a better application value in the enteral nutrition support after the percutaneous endoscopic gastrotomy,which can ensure the operation curative effect,prevent the occurrence of related complications and promote the gastrointestinal function,and it is conducive to early recovery.