治疗性护理对消化道出血患者内镜下止血效果的影响观察

Effect of therapeutic nursing on endoscopic hemostasis in patients with gastrointestinal bleeding

目的评价治疗性护理对消化道出血患者内镜下止血效果的影响。方法选取深圳市南山区人民医院2016年6月至2017年11月期间收治的120例消化道出血患者作为研究对象,均接受内镜下止血治疗,根据随机对照原则将其分为两组。对照组60例,接受常规护理干预;观察组60例,实施常规护理+治疗性护理干预。对比两组止血效果、临床相关指标,并观察干预前后心理状态、消化道出血危险性评分变化。结果观察组72 h再出血量[(42.87±7.93)ml比(216.93±31.53)ml,t=41.470,P=0.000],72 h再出血率(3.33%比20.00%,χ~2=8.086,P=0.005)均显著低于对照组,且一次性止血成功率(93.33%比75.00%,χ~2=7.566,P=0.006)显著高于对照组,差异均有统计学意义。24 h再出血率两组比较,差异无统计学意义。观察组干预前HADS量表评分与对照组相比,差异无统计学意义(P>0.05);观察组干预后HADS量表中抑郁评分[(4.53±1.18)分比(6.09±1.54)分,P<0.001]、焦虑评分[(4.28±1.22)分比(6.42±1.29)分,P<0.001]均显著低于对照组,差异均有统计学意义。观察组干预前BRS评分与对照组相比,差异无统计学意义(P>0.05);观察组干预后BRS评分<6分比例(78.33%比53.33%,P=0.004)显著高于对照组,差异有统计学意义。结论消化道出血患者内镜下止血治疗同时辅以治疗性护理干预有助于提高止血效果,降低再出血风险及出血量,缩短整体治疗时间,减轻患者负性情绪。

Objective To evaluate the effect of therapeutic nursing on endoscopic hemostasis in patients with gastrointestinal bleeding.Methods 120 cases of gastrointestinal bleeding patients admitted to our hospital from June2016 to November 2017 were selected as the study subjects,all of whom received endoscopic hemostasis treatment,and were divided into two groups according to the principle of random control.Control group of 60 cases,accept routine nursing intervention;Observation group 60 cases,the implementation of routine nursing+therapeutic nursing intervention.The hemostasis effect and clinical indexes of the two groups were compared,and the changes of mental state and gastrointestinal bleeding risk score before and after the intervention were observed.Results The success rate of one-time hemostasis(93.33%)in the observation group was higher than that in the control group(75.00%),and the rate of 72 h re-bleeding(3.33%)and the amount of re-bleeding(42.87±7.93)ml were lower than that in the control group(216.93±31.53)ml,with statistically significant differences(P<0.05).After intervention,the score of hospital anxiety and depression scale(HADS)in the observation group was lower than that in the control group,and the proportion of Blatchford risk score(BRS)<6 was higher than that in the control group,with statistically significant difference(P<0.05).Conclusion Endoscopic hemostasis combined with therapeutic nursing intervention for patients with gastrointestinal bleeding is helpful to improve hemostasis effect,reduce the risk of re-bleeding and bleeding,shorten the overall treatment time,and reduce the negative emotions of patients.