基于循证医学的优质护理服务在急性非静脉曲张性上消化道出血内镜治疗中的应用

Application of high quality nursing service based on evidence-based medicine in endoscopic treatment of acute non-variceal upper gastrointestinal bleeding

目的探讨基于循证医学的优质护理服务在急性非静脉曲张性上消化道出血内镜治疗中的应用价值。方法选取新疆医科大学第一附属医院收治的80例急性非静脉曲张性上消化道出血患者作为研究对象,均拟行内镜下止血治疗。随机将其分为观察组与对照组,对照组40例围手术期接受常规临床护理,观察组40例则接受基于循证医学理论的优质护理服务,比较2组内镜止血效果及相关治疗指标。结果护理前2组血红蛋白、血尿素氮、BRS评分比较无显著差异(P>0.05),护理后较护理前均明显改善,但观察组护理后各项指标改善效果与对照组比较存在显著差异(P<0.05);所有患者均成功止血,无患者病死发生,但观察组手术即时止血率明显高于对照组,住院期间再出血发生率明显低于对照组(P<0.05),观察组护理满意度评分、治疗依从性评分以及生活质量评分均明显高于对照组(P<0.05)。结论围手术期实施基于循证医学理论的优质护理服务可显著提升急性非静脉曲张性上消化道出血内镜止血的即时止血率,对改善患者血红蛋白、血尿素氮以及临床症状表现具有积极意义。

Objective To explore the application value of high quality nursing service based on evidence-based medicine in endoscopic treatment of acute non-variceal upper gastrointestinal bleeding.Methods A total of 80 patients with acute non-variceal upper gastrointestinal bleeding diagnosed in our hospital were selected as the study subjects.All patients were planned to undergo endoscopic hemostasis.Random number table method was used to divide them into observation group and control group.The 40 cases in control group received routine clinical nursing during perioperative period,while another 40 cases in observation group received high quality nursing service based on evidence-based medicine theory.Results There was no significant difference in the scores of hemoglobin,blood urea nitrogen and BRS between the two groups before and after nursing(P>0.05).After nursing,the scores of hemoglobin,blood urea nitrogen and BRS improved significantly compared with before nursing,but there was significant difference between the observation group and the control group after nursing(P<0.05).All patients succeeded in hemostasis and no death occurred,but the immediate hemostasis rate of the observation group was significantly higher than that of the control group during hospitalization.The incidence of rebleeding was significantly lower in the observation group than in the control group(P<0.05),and the scores of nursing satisfaction,treatment compliance and quality of life in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The application of high-quality nursing service based on evidence-based medicine theory in the perioperative period of endoscopic treatment for patients with acute non-variceal upper gastrointestinal hemorrhage can significantly improve the immediate hemostasis rate of endoscopic hemostasis,improve hemoglobin,blood urea nitrogen and clinical symptomst.