基于奥马哈系统的个案管理模式应用于肝硬化合并消化道出血患者的效果

Effect of Case Management Model Based on Omaha System Applied to Patients with Liver Cirrhosis Complicated with Gastrointestinal Bleeding

目的:探讨基于奥马哈系统的个案管理模式应用于肝硬化合并消化道出血患者的效果。方法:选择联勤保障部队第九〇九医院2020年2月—2022年4月收治的87例肝硬化合并消化道出血患者,按照计算机分组法分为两组,对照组(n=43)给予常规护理管理,观察组(n=44)给予基于奥马哈系统的个案管理。观察两组恢复情况、再出血发生率及心理状态。结果:观察组引流管转清时间、呕血消失时间、大便潜血转阴时间、住院时间优于对照组,再就诊次数少于对照组,差异有统计学意义(P<0.05);观察组再出血发生率低于对照组,差异有统计学意义(P<0.05)。观察组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均低于对照组,差异有统计学意义(P<0.05)。结论:基于奥马哈系统的个案管理模式具有良好的护理效果,能够改善肝硬化合并消化道出血患者临床结局,降低再出血发生率,有效缓解患者不良心理状态。

Objective:To explore the effect of case management model based on Omaha system applied to patients with liver cirrhosis complicated gastrointestinal bleeding.Method:A total of 87 patients with liver cirrhosis complicated gastrointestinal bleeding admitted to the 909th Hospital of the Joint Logistics Support Force from February 2020 to April 2022 were selected.According to the computer grouping method,they were divided into two groups,the control group(n=43)was given routine nursing management,and the observation group(n=44)was given case management model based on the Omaha system.The recovery,incidence of rebleeding,and psychological status of the two groups were observed.Result:The drainage tube clearance time,hematemesis disappearance time,stool occult blood negative conversion time,and hospitalization time in the observation group were better than those in the control group,and the number of re-visit was less than that in the control group,the differences were statistically significant(P<0.05).The incidence of rebleeding in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The case management model based on the Omaha system has good nursing effects,which can improve the clinical outcomes of patients with liver cirrhosis combined with gastrointestinal bleeding,reduce the incidence of rebleeding,and effectively alleviate the negative psychological state of patients.