中医护理联合集束化护理在急性重症胰腺炎患者护理中的应用效果

Effect of traditional Chinese medicine care combined with cluster care in the care of patients with severe acute pancreatitis

目的探析在急性重症胰腺炎(SAP)患者治疗过程中实施联合护理方案(中医护理^(+)集束化护理)的临床效果及对患者免疫功能、炎症因子、胰腺损伤生化指标的影响。方法选取2020年7月-2021年6月在河南省某医院接受中西医治疗的84例SAP患者为研究对象,采用随机数字表法将患者分为观察组和对照组,各42例。对照组患者给予集束化护理,观察组患者给予联合护理方案(中医护理^(+)集束化护理)。比较2组患者干预前及干预2周时免疫功能指标[T淋巴细胞亚群(CD4^(+)、CD8^(+))、CD4^(+)/CD8^(+)]、炎症指标[白细胞(WBC)、C反应蛋白(CRP)、白介素-6(IL-6)、内毒素(LPS)]、胰腺损伤生化指标[血清淀粉酶(AMY)、脂肪酶(LIP)]。结果干预前,2组患者CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05);干预后,2组患者CD4^(+)、CD4^(+)/CD8^(+)水平高于干预前,且观察组高于对照组;2组患者CD8^(+)水平低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者WBC、CRP、IL-6、LPS水平比较,差异无统计学意义(P>0.05);干预后,2组患者WBC、CRP、IL-6、LPS水平低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者AMY、LIP水平比较,差异无统计学意义(P>0.05)。干预后,2组患者AMY、LIP水平低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论中西医疗法(柴芩承气汤^(+)乌司他丁)治疗过程中实施联合护理方案(中医护理^(+)集束化护理),可有效改善患者免疫功能,控制炎症反应,减轻胰腺损伤,值得临床推广应用。

Objective To investigate the clinical effect of implementing a combined nursing program(traditional Chinese medicine nursing^(+)cluster nursing)in the treatment of patients with severe acute pancreatitis(SAP)and the effect on patients′immune function,inflammatory factors,and biochemical indicators of pancreatic injury.Methods Eighty-four patients with SAP who received Chinese and Western medicine treatment in a hospital in Henan from July 2020 to June 2021 were selected as study subjects,and the patients were divided into observation and control groups of 42 cases each using the random number table method.Patients in the control group were given cluster care,and patients in the observation group were given a combined care plan(traditional Chinese medicine care^(+)cluster care).The immune function indicators[T lymphocyte subsets(CD4^(+),CD8^(+)),CD4^(+)/CD8^(+)],inflammation indicators[white blood cells(WBC),C-reactive protein(CRP),interleukin-6(IL-6),lipopolysaccharide(LPS)],and biochemical indicators of pancreatic injury[serum amylase(AMY),lipase(LIP)]were compared between the 2 groups of patients before and at 2 weeks of intervention.Results Before the intervention,there was no statistically significant difference between the CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)levels in the 2 groups(P>0.05);after the intervention,the CD4^(+)and CD4^(+)/CD8^(+)levels in the 2 groups were higher than before the intervention and higher in the observation group than in the control group;the CD8^(+)levels in the 2 groups were lower than before the intervention and lower in the observation group than in the control group.All differences were statistically significant(P<0.05).Before the intervention,there was no statistically significant difference between the WBC,CRP,IL-6 and LPS levels in the 2 groups(P>0.05);after the intervention,the WBC,CRP,IL-6 and LPS levels in the 2 groups were lower than before the intervention and lower in the observation group than in the control group,with statistically significant differences(P<0.05).Before the intervention,there was no statistically significant difference between the AMY and LIP levels in the 2 groups(P>0.05).After the intervention,the AMY and LIP levels in the 2 groups were lower than before the intervention and lower in the observation group than in the control group,with statistically significant differences(P<0.05).Conclusion The implementation of combined nursing scheme(traditional Chinese medicine nursing^(+)cluster nursing)in the course of Chinese and Western medicine therapy(Chai Qin Cheng Qi Decoction^(+)Ustatin)has significant clinical effects.It can effectively improve the immune function of patients,control the inflammatory response and reduce pancreatic injury,and is worthy of clinical promotion and application.