FMEA在肝硬化并发上消化道出血患者中的应用

Application of FMEA in Patients with Cirrhosis Complicated by Upper Gastrointestinal Hemorrhage

目的:探讨失效模式与效应分析(FMEA)在肝硬化并发上消化道出血患者中的应用效果。方法:选取2018年1月1日~2019年12月1日收治的80例肝硬化并发上消化道出血患者,按照随机数字表法将患者分为观察组和对照组各40例。对照组给予常规护理,观察组在常规护理基础上应用FMEA;比较两组干预前及干预2周后自我管理依从性[采用成年人健康自我管理能力测评量表(AHSMSRS)]、自我效能感[采用一般自我效能感量表(GSES)]、计算风险系数(RPN值)及再出血率。结果:干预2周后,两组AHSMSRS、GSES评分均高于干预前,且观察组高于对照组(P<0.05);干预2周后,两组RPN值低于干预前(P<0.05),且观察组低于对照组(P<0.05);观察组再出血率低于对照组(P<0.05)。结论:对肝硬化并发上消化道出血患者实施FMEA,能够提高患者自我管理依从性、自我效能感,降低患者再出血率。

Objective:To investigate the efficacy of failure model and effect analysis(FMEA)in patients with cirrhosis complicated with upper gastrointestinal bleeding.Methods:From January 1,2018 to December 1,2019,80 patients with cirrhosis complicated with upper gastrointestinal bleeding were selected and divided into observation group and control group according to the random number table method,with 40 patients in each group.The control group was given routine nursing,and the observation group was given FMEA on the basis of routine nursing.Self-management compliance(AHSMSRS),self-efficacy(GSES),risk priority number(RPN)and rebleeding rate were compared between the two groups before and 2 weeks after intervention.Results:After 2 weeks of intervention,scores of AHSMSRS and GSES in both groups were higher than those before intervention,and those in the observation group were higher than those in the control group(P<0.05).After 2 weeks of intervention,the RPN value of the two groups was lower than that before intervention,and the observation group was lower than that of the control group(P<0.05).The rate of rebleeding in the observation group was lower than that in the control group(P<0.05).Conclusion:The implementation of FMEA in patients with cirrhosis complicated with upper gastrointestinal hemorrhage can improve patients′self-management compliance and self-efficacy,and reduce the rate of rebleeding.