饮食护理联合预见性护理在上消化道出血滞留抢救室患者中应用的临床效果及对血清炎症因子的影响

The Clinical Effect of Diet Nursing Combined with Predictive Nursing in Patients with Upper Gastrointestinal Bleeding in the Rescue Room and Its Influence on Serum Inflammatory Factors

目的探讨饮食护理联合预见性护理在上消化道出血患者临床护理中的效果。方法选取2017年1—10月在该院消化内科住院的上消化道出血患者120例作为研究对象,按照随机数字法则,分为两组,每组60例,对照组在基础护理基础上予以饮食护理模式,联合组在对照组护理基础上辅助预见性护理模式,随访6个月,对比两组患者出血次数、止血时间、干预后总有效率、出血率。护理前和护理后2周,采用酶联免疫法检测C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)。结果联合组出血次数为(3.02±0.97)次,止血时间为(22.48±3.89)h,明显少于对照组[(出血次数为(6.58±1.14)次,止血时间为(40.19±4.02)h],差异有统计学意义(t=18.423、24.523,P<0.05);联合组总有效率为83.33%,显著高于对照组的总有效率(66.67%),差异有统计学意义(χ^(2)=4.444,P=0.035),联合组干预后再次出血的出血率为3.33%,显著低于对照组(13.33%),差异有统计学意义(χ^(2)=3.927,P=0.048);护理前,两组的CRP、IL-6、TNF-α水平差异无统计学意义(P>0.05),经过两周护理后两组患者的CRP、IL-6、TNF-α水平均较护理前明显降低,而护理后联合组的CRP、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。结论饮食护理联合预见性护理能够显著提高上消化出血患者的治疗效果,且能够明显降低血清炎症因子水平。

Objective To explore the effect of diet nursing combined with predictive nursing in the clinical nursing of patients with upper gastrointestinal bleeding.Methods A total of 120 patients with upper gastrointestinal bleeding who were hospitalized in the Gastroenterology Department of the hospital from January to October 2017 were selected as the research objects.According to the random number rule,they were divided into two groups,with 60 cases in each group.The control group was based on basic nursing,diet nursing model was given.The combined group assisted the predictive nursing model on the basis of the control group.The patients were followed up for 6 months to compare the number of bleeding,hemostasis time,total effective rate after intervention,and bleeding rate between the two groups.Before nursing and 2 weeks after nursing,C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunoassay.Results The number of bleeding in the combined group was(3.02±0.97)times,and the time to hemostasis was(22.48±3.89)h,which was significantly less than that of the control group[the number of bleeding was(6.58±1.14)times and the time to hemostasis was(40.19±4.02)h].The difference was statistically significant(t=18.423,24.523,P<0.001);the total effective rate of the combination group was 83.33%,which was significantly higher than the total effective rate of the control group(66.67%),the difference was statistically significant(χ^(2)=4.444,P=0.035),the bleeding rate of re-bleeding after intervention in the combined group was 3.33%,which was significantly lower than that in the control group(13.33%),the difference was statistically significant(χ^(2)=3.927,P=0.048);before nursing,CRP,IL-6,TNF-αlevels was not statistically significant difference(P>0.05).After two weeks of nursing,the levels of CRP,IL-6,and TNF-αin the two groups were significantly lower than those before nursing,while CRP and IL-6 in the combined group after nursing,TNF-αlevel was lower than the control group,the difference was statistically significant(P<0.05).Conclusion The combination of diet care and predictive care can significantly improve the treatment effect of patients with upper gastrointestinal bleeding,and can significantly reduce the level of serum inflammatory factors.