以休克体位为主的专项护理对肝硬化并消化道出血患者并发症的影响

Effect of special nursing with shock position on complications of patients with cirrhosis and gastrointestinal hemorrhage

目的探究以休克体位为主的专项护理是否对血流动力学稳定的肝硬化并消化道出血患者有意义。方法选取2017年6月至2018年5月在本院消化内科诊断为肝硬化并消化道出血的92例患者为实验组;另将2016年6月至2017年5月本院收治的肝硬化并消化道出血的79例患者设为对照组。对照组采用以平卧位为主的护理模式,实验组采用以休克体位结合平卧位为主的专项护理模式;比较两组血压、中心静脉压、呼吸频率、血氧饱和度、误吸、休克、患者及患者家属满意度与护理投诉。结果与对照组相比,实验组平均中心静脉压更趋于正常[(9.7±4.2)cmH20(1 cmH20=98 Pa)比(7.4±4.3)cmH20],实验组平均呼吸频率更平稳[(8.5±1.5)次比(12.6±3.4)次],实验组平均血氧饱和度更高[(89.5±6.5)%比(78.5±3.5)%]。实验组并发症发生率、护理投诉率少于对照组[(0.00%比3.79%)和(1.09%比7.59%)];同时实验组满意度高于对照组(97.82%比72.15%);两组差异均有统计学意义(均P<0.05)。结论采用休克体位为主的专项护理有助于减轻血流动力学稳定的肝硬化并消化道出血患者的症状,利于该类患者病情的恢复,值得广泛采用。

Objective To explore whether special nursing with shock posture is significant for patients with hemodynamically stable cirrhosis and gastrointestinal bleeding.Methods 92 liver cirrhosis patients complicated with gastrointestinal hemorrhage treated at our hospital from June,2017 to May,2018 were selected as a research group.79 liver cirrhosis patients complicated with gastrointestinal hemorrhage treated at our hospital from June,2016 to May,2017 were selected as a control group.The control group applied supine position nursing mode.The research group applied nursing mode of shock position and supine position.The blood pressure,central venous pressure,respiratory frequency,blood oxygen saturation,mistaken inhalation,shock,satisfaction of patients and their family members,and nursing complaints were compared between the two groups.Results The central venous pressure,respiratory frequency,and blood oxygen saturation were better in the research group than in the control group[(9.7±4.2)cmH20(1 cmH20=98 Pa)vs.(7.4±4.3)cmH20,(8.5±1.5)times vs.(12.6±3.4)times,and(89.5±6.5)%vs.(78.5±3.5)%;all P<0.05].The rates of complications and nursing complaints were lower and the satisfaction rate was higher in the research group than in the control group(0.00%vs.3.79%,1.09%vs.7.59%,and 97.82%vs.72.15%;all P<0.05).Conclusion Special nursing with shock posture as the main method is helpful to alleviate the symptoms of patients with hemodynamically stable cirrhosis and gastrointestinal hemorrhage and to recover their conditions,so it is worthy of widespread adoption.