基于胰瘘风险评分模型的分级护理模式在胰十二指肠切除术后患者中的应用

Application of graded nursing based on pancreatic fistula risk score model for patients after pancreaticoduodenectomy

目的:探讨基于胰瘘风险评分(FRS)模型的分级护理模式在胰十二指肠切除术(PD)后患者中的应用价值。方法:纳入196例行PD患者为研究对象,按护理模式分为对照组和观察组,分别96例和100例。对照组实施常规护理,观察组在实施常规护理的基础上加上基于FRS模型的分级护理,比较两组患者总体并发症发生率、胰瘘发生率及生命质量。结果:观察组总体并发症发生率为29.0%,低于对照组的42.7%,差异具有统计学意义(χ^(2)=16.272,P<0.01)。观察组胰瘘总发生率和B、C级胰瘘发生率分别为16.0%和13.0%,均显著低于对照组的26.0%和21.9%(χ^(2)=7.573,P<0.01和χ^(2)=5.735,P<0.05)。观察组患者术后1个月与术前的生命质量评分差值均高于对照组,两组比较差异有统计学意义(P<0.05)。结论:PD术后患者实施基于FRS模型的分级护理模式,能够减少总体并发症发生率及胰瘘发生率,尤其是B、C级胰瘘的发生率,且能提高患者生命质量,有较高的临床推广应用价值。

Objective:To investigate the value of graded nursing based on pancreatic fistula risk score(FRS)model in patients after pancreaticoduodenectomy(PD).Methods:Totally 196 patients who underwent PD were enrolled in the study and divided into a control group(96 cases)and an observation group(100 cases)according to the nursing model.The control group carried out routine nursing,and the observation group added graded nursing based on the FRS model on the basis of routine nursing.The overall incidence of complications,incidence of pancreatic fistula and quality of life were compared between the two groups.Results:The overall incidence of complications,in the observation group was 29.0%,which was lower than 42.7%in the control group,and the difference was statistically significant(χ^(2)=16.272,P<0.01).The incidence of pancreatic fistula was 16.0%and the incidence of grade B and grade C pancreatic fistula was 13.0%in the observation group,which were significantly lower than 26.0%and 21.9%in the control group(χ^(2)=7.573,P<0.01 andχ^(2)=5.735,P<0.05).The differences in the quality of life scores between the observation group and the control group at 1 month after operation was higher than that of the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:Applying graded nursing based on FRS model to patients after PD can reduce the overall incidence of complications and pancreatic fistula,especially the incidence of grade B and C pancreatic fistula,and also improve the quality of life.