基于BISAP-HDL预警模型联合集束化护理在急性胰腺炎患者中的应用效果

Application effect of early warning model based on BISAP-HDL combined with cluster nursing in patients with acute pancreatitis

目的探讨床旁指数-高密度脂蛋白(BISAP-HDL)预警模型联合集束化护理在急性胰腺炎(AP)中的应用效果。方法前瞻性选取2021年2月至2022年2月中国人民解放军联勤保障部队第九〇四医院治疗的80例AP患者为研究对象,通过随机数字表法将患者分为对照组(n=42)和观察组(n=38)。对照组给予集束化护理,观察组给予基于BISAP-HDL预警模型联合集束化护理。比较治疗前24 h、治疗后1周两组急性生理与慢性健康评分Ⅱ(APACHEⅡ)、BISAP-HDL评分,两组住院时间、腹痛缓解时间和淀粉酶恢复时间、治疗前后免疫功能、炎症因子水平,两组入院28 d病死率情况。结果治疗后1周,两组APACHEⅡ、BISAP-HDL评分均低于治疗前24 h,且观察组低于对照组(P<0.05)。观察组住院时间,腹痛缓解时间和血、尿淀粉酶恢复正常时间均短于对照组(P<0.05)。治疗后,两组CD4^(+)高于治疗前,且观察组高于对照组(P<0.05),而两组CD8^(+)、免疫球蛋白G、白细胞介素-6、肿瘤坏死因子-α和C反应蛋白低于治疗前,且观察组低于对照组(P<0.05)。观察组和对照组入院28 d病死率分别为7.89%(3/38)和16.67%(7/42),比较差异无统计学意义(P>0.05)。结论BISAP-HDL预警模型联合集束化护理有利于AP患者恢复,改善其免疫功能和炎症因子水平。

Objective To explore the application effect of early warning model based on bedside index for severity in acute pancreatitis-high density lipoprotein(BISAP-HDL)combined with cluster nursing in patients with acute pancreatitis(AP).Methods Eighty AP patients treated in the 904th Hospital of Joint Support Force of Chinese People’s Liberation Army from February 2021 to February 2022 were prospectively selected as the study objects,they were divided into control group(n=42)and observation group(n=38)by random number table method.The control group was given cluster nursing,and the observation group was given early warning model nursing based on BISAP-HDL combined wite cluster.Acute physiological and chronic health scoresⅡ(APACHEⅡ),BISAP-HDL scores,length of hospital stay,abdominal pain relief time,amylase recovery time,immune function and inflammatory factor levels before and after treatment were compared between the two groups 24 h before treatment and one week after treatment,and the mortality rate at 28 days after admission was compared between the two groups.Results One week after treatment,the scores of APACHEⅡand BISAP-HDL in both groups were lower than those before 24 h treatment,and the observation group was lower than the control group(P<0.05).The hospitalization time,abdominal pain relief time and hematuric amylase recovery time in observation group were shorter than those in control group(P<0.05).After treatment,CD4^(+)in both groups was higher than those before treatment,and the observation group was higher than that of the control group(P<0.05).CD8^(+),immunoglobulin G,interleukin-6,tumor necrosis factor-α,and C-reactive protein in two groups were lower than those before treatment,and observation group was lower than control group(P<0.05).The fatality rate at 28 days after admission in the observation group and the control group was 7.89%(3/38)and 16.67%(7/42),respectively,with no significant difference(P>0.05).Conclusion Early warning model based on BISAP-HDL combined with cluster nursing is beneficial to the recovery of AP patients,improving their immune function and inflammatory factor levels.