益生菌治疗联合知信行理论模型管理对重症急性胰腺炎患者机体恢复情况及生活质量的影响

The effect of probiotic therapy combined with the knowledge-attitude-practice model on the recovery and quality of life of patients with acute severe pancreatitis

目的 研究益生菌治疗联合知信行(KAP)理论模型管理对重症急性胰腺炎患者机体恢复情况及生活质量的影响。方法 选取2020年6月至2023年6月衢州市人民医院重症急性胰腺炎患者,分为对照组、益生菌组和KAP联合组。3组均给予对症支持治疗,对照组予以常规护理;益生菌组在此基础上每日口服益生菌颗粒;KAP联合组在益生菌治疗基础上,采用KAP理论模型管理,包括疾病知识维度、行为维度和信念维度的针对性干预。比较3组患者治疗前后急性生理学与慢性健康评分体系(APACHEII)评分、生活质量(QOL-C30)评分、自我管理能力,以及血清炎性因子C-反应蛋白(CRP)和降钙素原(PCT)等指标的变化。结果 研究共纳入108例患者,每组均为36例。治疗后,3组CRP和PCT较治疗前均显著下降(P <0.05),益生菌组和KAP联合组下降幅度均显著大于对照组(P <0.05);治疗后3组自我管理能力较治疗前显著增强(P <0.05),KAP联合治疗组增加幅度显著大于益生菌组和对照组(P <0.05);益生菌组和KAP联合治疗组APACHE II评分较治疗前显著下降(P <0.05),QOL-C30评分显著升高(P <0.05)。结论 益生菌治疗可显著改善重症急性胰腺炎的炎症状态、临床症状和生活质量;知信行理论模型管理可进一步增强益生菌治疗的效果,安全有效地提高患者的机体恢复能力和生活质量。

Objective To investigate the effects of probiotic treatment combined with knowledge attitude and practice(KAP)model management on the recovery and quality of life of patients with severe acute pancreatitis.Methods Patients with severe acute pancreatitis from June 2020 to June 2023 in Quzhou People's Hospital were selected.The patients were divided into the control group,the probiotics group and the KAP combination group.All groups received symptomatic treatment.The control group was given routine nursing,the probiotic group was given daily oral administration of probiotic granules,and the KAP combination group was managed by KAP model on the basis of probiotic treatment,including targeted intervention in the dimensions of disease knowledge,behavior and belief.The APACHE II scores,quality of life scale QOL-C30 scores,serum inflammatory factors C-reactive protein(CRP)and procalcitonin(PCT)levels were compared before and after treatment in three groups.Results A total of 108 patients were included,with 36 cases in each group.The CRP and PCT decreased significantly after treatment in three groups(P<0.05).The reduction ranges of the probiotics group and the KAP group were significantly higher than that of the control group(P<0.05).The self-management ability was significantly increased in all three groups after treatment compared to before treatment(P<0.05),and the increase was significantly greater in the KAP combination treatment group than in the probiotic and control groups(P<0.05).The APACHE II scores decreased significantly and QOL-C30 scores increased significantly after treatment in the probiotics group and the KAP group(P<0.05).Conclusion Probiotic treatment could significantly improve the inflammatory status,clinical symptoms and quality of life of patients with severe acute pancreatitis.The KAP model management could further enhance the effect of probiotic treatment,effectively improve patients’organism recovery ability and quality of life.