综合护理干预对百草枯中毒患者hs-CRP、IL-10、ASL、ALT水平影响
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摘要
为分析综合护理干预对百草枯中毒患者临床治疗预后的效果,本研究选取2015年5月至2016年12月我院收治的百草枯中毒患者92例,根据护理方法不同分为对照组和观察组。对照组患者采用常规护理模式进行干预,观察组患者采用综合护理模式进行干预,分析两组患者护理后的效果。研究发现,观察组患者治愈率、7 d存活率和30 d存活率高于对照组,口腔黏膜愈合时间、住院时间短于对照组(p<0.05)。干预前,两组患者hs-CRP、IL-10、ASL、ALT水平比较无统计学差异(p>0.05)。干预后,观察组患者hs-CRP、IL-10、ASL、ALT水平低于对照组(p<0.05)。干预前,两组患者焦虑、抑郁评分比较无统计学差异(p>0.05)。干预后,观察组患者焦虑、抑郁评分低于对照组(p<0.05)。本研究的结果说明,百草枯中毒患者采用综合护理干预可加快患者口腔黏膜愈合时间,提高治愈率、存活率,改善患者心理状况,值得临床推广及进一步规范研究。
To analyze the effect of comprehensive nursing intervention on the prognosis of clinical treatment of paraquat poisoning patients, 92 cases from May 2015 to December 2016 in our hospital were selected and divided into control group and observation group according to the different nursing methods. The control group was treated with conventional nursing intervention, and the observation group was treated with comprehensive nursing intervention, and the nursing effect were analyzed. Research found that the cure rate, survival rate in 7 d and 30 d of the patients in the observation group were higher than that in the control group. The healing time of oral mucosa and the hospitalization time were also shorter than that of the control group(p<0.05). Before the intervention, there was no statistical difference in the level of hs-CRP, IL-10, ASL, ALT in two groups of patients(p>0.05). After intervention, the level of hs-CRP, IL-10, ASL, ALT in the observation group were significantly lower than in the control group(p<0.05). Before intervention, there was no statistical difference in anxiety and depression score between the two groups of patients(p>0.05). After intervention, the anxiety and depression scores in the observation group were lower than that in control group(p<0.05). The result in this study indicated that comprehensive nursing intervention in paraquat poisoning patients could accelerate the healing time of oral mucosa, improve the cure rate and survival rate, and improve the psychological status of the patients, which would be worth spreading and further researching.
To analyze the effect of comprehensive nursing intervention on the prognosis of clinical treatment of paraquat poisoning patients, 92 cases from May 2015 to December 2016 in our hospital were selected and divided into control group and observation group according to the different nursing methods. The control group was treated with conventional nursing intervention, and the observation group was treated with comprehensive nursing intervention, and the nursing effect were analyzed. Research found that the cure rate, survival rate in 7 d and 30 d of the patients in the observation group were higher than that in the control group. The healing time of oral mucosa and the hospitalization time were also shorter than that of the control group(p<0.05). Before the intervention, there was no statistical difference in the level of hs-CRP, IL-10, ASL, ALT in two groups of patients(p>0.05). After intervention, the level of hs-CRP, IL-10, ASL, ALT in the observation group were significantly lower than in the control group(p<0.05). Before intervention, there was no statistical difference in anxiety and depression score between the two groups of patients(p>0.05). After intervention, the anxiety and depression scores in the observation group were lower than that in control group(p<0.05). The result in this study indicated that comprehensive nursing intervention in paraquat poisoning patients could accelerate the healing time of oral mucosa, improve the cure rate and survival rate, and improve the psychological status of the patients, which would be worth spreading and further researching.
引文
Dong Y.,2015,Nursing care of oral and esophageal mucous membrane in patients with acute poisoning,Zhongguo Yike Daxue Xuebao(Journal of China Medical University),44(9):860-861(董赢,2015,急性百草枯中毒合并严重口腔及食道损伤的黏膜护理,中国医科大学学报,44(9):860-861)
Huang M.,Lou D.,Li H.H.,Cai Q.,Wang Y.P.,and Yang H.F.,2016,Pyrrolidine dithiocarbamate attenuates paraquat-induced acute pulmonary poisoning in vivo via transforming growth factorβ1 and nuclear factorκB pathway interaction,Hum.Exp.Toxicol.,35(12):1312-1318
Liu G.,Song D.M.,Jiang Y.,Zhu L.Q.,and Ge Y.,2015,Expression of heme oxygenase-1 in lung tissue of paraquat poisoned mice and its significance,Zhonghua Weizhongbing Jijiu Yixue(Chinese Critical Care Medicine),11(4):280-284(刘刚,宋冬梅,江宇,朱丽青,葛赟,2015,血红素氧合酶-1在急性百草枯中毒小鼠肺组织中的表达及意义,中华危重病急救医学,11(4):280-284)
Liu J.Y.,Guo Y.J.,Song Y.Z.,and Lin D.J.,2017,The predictive value of matrix metalloproteinase-9 for prognosis of patients with paraquat poisoning,Zhongguo Zhongxiyi Jiehe Jijiu Zazhi(Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care),24(2):147-150(刘景艳,郭玉娟,宋永站,林殿杰,2017,基质金属蛋白酶-9对百草枯中毒患者预后的预测价值,中国中西医结合急救杂志,24(2):147-150)
Mo J.,Chen X.B.,Xu T.,Wang Y.L.,and Liu K.X.,2015,Clearance rate of strengthened hemoperfusion for acute paraquat poisoning and its effects on patients'prognosis,Zhongguo Quanke Yixue(Chinese General Practice),18(8):933-936(莫军,陈晓兵,许铁,王言理,刘克喜,2015,强化血液灌流对急性百草枯中毒患者血清百草枯清除率和预后的影响,中国全科医学,18(8):933-936)
Mu D.D.,Su S.,Jin J.Q.,Han Y.,Liu H.W.,and Huang Y.Q.,2016,A case-control study of relation of xerostomia to anxiety and depression symptoms in patients with burning mouth syndrome,Zhongguo Xinli Weisheng Zazhi(Chinese Mental Health Journal),30(4):253-257(木冬冬,苏莎,金建秋,韩莹,刘宏伟,黄悦勤,2016,灼口综合征口干症状与焦虑抑郁症状的病例对照研究,中国心理卫生杂志,30(4):253-257)
Shang A.D.,and Lu Y.Q.,2015,A case report of severe paraquat poisoning in an HIV-positive patient:an unexpected outcome and inspiration,Medicine,94(8):e587
Wang W.Z.,Qi H.N.,Gao Z.,Ziao Q.M.,Zhu B.Y.,Li W.,Liu Y.J.,Li J.,Wang P.,and Ma G.Y.,2016,The effect of soluble CD14-st on the assessment and prognosis of patients with acute paraquat poisoning,Zhonghua Jizheng Yiue Zazhi(Chinese Journal of Emergency Medicine),25(9):1159-1165(王维展,齐洪娜,高繤,肖青勉,朱保月,李伟,刘永建,李敬,王璞,马国营,2016,可溶性CD14亚型对急性百草枯中毒患者的病情评估及预后的影响,中华急诊医学杂志,25(9):1159-1165)
Wang Z.,Ma J.,Zhang M.,Wen C.,Huang X.,Sun F.,Wang S.,Hu L.,Lin G.,and Wang X.,2015,Serum metabolomics in rats after acute paraquat poisoning,Biol.Pharm.Bull.,38(7):1049-1053
Xu W.,Wang L.,Wang Q.,Li X.H.,Hu D.,Li C.,Wu T.,Mohan C.,Peng A.,and Shi Y.,2015,Paraquat poisoning followed by toxic epidermal necrolysis:a report of two cases and published work review,Dermatology,231(3):209-212
Yao D.Q.,Li M.,Gao H.B.,Wang X.,Su J.L.,Gong Y.,Meng Z.H.,Wang R.Y.,and Tian Y.P.,2016,Follow-up of the pulmonary function in long-term survival patients with acute paraquat poisoning,Zhonghua Jizheng Yiue Zazhi(Chinese Journal of Emergency Medicine),25(6):792-796(姚冬奇,李敏,高恒波,王霞,苏建玲,宫玉,孟兆华,王荣英,田英平,2016,长期存活急性百草枯中毒患者肺功能的随访研究,中华急诊医学杂志,25(6):792-796)
Zhou C.Y.,Kang X.,Li C.B.,Li X.H.,Liu Y.,Wang Z.,Wang L.,Wu T.,Mohan C.,Hu D.Y.,and Peng A.,2015,Pneumomediastinum predicts early mortality in acute paraquat poisoning,Clinical Toxicology,53(6):551-556
Zhou Y.,Sun X.R.,Liu X.L.,and Yan S.X.,2016,Effect of psychological intervention on the treatment of oral lichen planus,Guoji Kouqiang Yixue Zazhi(International Journal of Stomatology),43(1):22-25(周毅,孙秀荣,刘学丽,闫世霞,2016,心理干预对口腔扁平苔藓治疗效果的影响,国际口腔医学杂志,43(1):22-25)
Huang M.,Lou D.,Li H.H.,Cai Q.,Wang Y.P.,and Yang H.F.,2016,Pyrrolidine dithiocarbamate attenuates paraquat-induced acute pulmonary poisoning in vivo via transforming growth factorβ1 and nuclear factorκB pathway interaction,Hum.Exp.Toxicol.,35(12):1312-1318
Liu G.,Song D.M.,Jiang Y.,Zhu L.Q.,and Ge Y.,2015,Expression of heme oxygenase-1 in lung tissue of paraquat poisoned mice and its significance,Zhonghua Weizhongbing Jijiu Yixue(Chinese Critical Care Medicine),11(4):280-284(刘刚,宋冬梅,江宇,朱丽青,葛赟,2015,血红素氧合酶-1在急性百草枯中毒小鼠肺组织中的表达及意义,中华危重病急救医学,11(4):280-284)
Liu J.Y.,Guo Y.J.,Song Y.Z.,and Lin D.J.,2017,The predictive value of matrix metalloproteinase-9 for prognosis of patients with paraquat poisoning,Zhongguo Zhongxiyi Jiehe Jijiu Zazhi(Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care),24(2):147-150(刘景艳,郭玉娟,宋永站,林殿杰,2017,基质金属蛋白酶-9对百草枯中毒患者预后的预测价值,中国中西医结合急救杂志,24(2):147-150)
Mo J.,Chen X.B.,Xu T.,Wang Y.L.,and Liu K.X.,2015,Clearance rate of strengthened hemoperfusion for acute paraquat poisoning and its effects on patients'prognosis,Zhongguo Quanke Yixue(Chinese General Practice),18(8):933-936(莫军,陈晓兵,许铁,王言理,刘克喜,2015,强化血液灌流对急性百草枯中毒患者血清百草枯清除率和预后的影响,中国全科医学,18(8):933-936)
Mu D.D.,Su S.,Jin J.Q.,Han Y.,Liu H.W.,and Huang Y.Q.,2016,A case-control study of relation of xerostomia to anxiety and depression symptoms in patients with burning mouth syndrome,Zhongguo Xinli Weisheng Zazhi(Chinese Mental Health Journal),30(4):253-257(木冬冬,苏莎,金建秋,韩莹,刘宏伟,黄悦勤,2016,灼口综合征口干症状与焦虑抑郁症状的病例对照研究,中国心理卫生杂志,30(4):253-257)
Shang A.D.,and Lu Y.Q.,2015,A case report of severe paraquat poisoning in an HIV-positive patient:an unexpected outcome and inspiration,Medicine,94(8):e587
Wang W.Z.,Qi H.N.,Gao Z.,Ziao Q.M.,Zhu B.Y.,Li W.,Liu Y.J.,Li J.,Wang P.,and Ma G.Y.,2016,The effect of soluble CD14-st on the assessment and prognosis of patients with acute paraquat poisoning,Zhonghua Jizheng Yiue Zazhi(Chinese Journal of Emergency Medicine),25(9):1159-1165(王维展,齐洪娜,高繤,肖青勉,朱保月,李伟,刘永建,李敬,王璞,马国营,2016,可溶性CD14亚型对急性百草枯中毒患者的病情评估及预后的影响,中华急诊医学杂志,25(9):1159-1165)
Wang Z.,Ma J.,Zhang M.,Wen C.,Huang X.,Sun F.,Wang S.,Hu L.,Lin G.,and Wang X.,2015,Serum metabolomics in rats after acute paraquat poisoning,Biol.Pharm.Bull.,38(7):1049-1053
Xu W.,Wang L.,Wang Q.,Li X.H.,Hu D.,Li C.,Wu T.,Mohan C.,Peng A.,and Shi Y.,2015,Paraquat poisoning followed by toxic epidermal necrolysis:a report of two cases and published work review,Dermatology,231(3):209-212
Yao D.Q.,Li M.,Gao H.B.,Wang X.,Su J.L.,Gong Y.,Meng Z.H.,Wang R.Y.,and Tian Y.P.,2016,Follow-up of the pulmonary function in long-term survival patients with acute paraquat poisoning,Zhonghua Jizheng Yiue Zazhi(Chinese Journal of Emergency Medicine),25(6):792-796(姚冬奇,李敏,高恒波,王霞,苏建玲,宫玉,孟兆华,王荣英,田英平,2016,长期存活急性百草枯中毒患者肺功能的随访研究,中华急诊医学杂志,25(6):792-796)
Zhou C.Y.,Kang X.,Li C.B.,Li X.H.,Liu Y.,Wang Z.,Wang L.,Wu T.,Mohan C.,Hu D.Y.,and Peng A.,2015,Pneumomediastinum predicts early mortality in acute paraquat poisoning,Clinical Toxicology,53(6):551-556
Zhou Y.,Sun X.R.,Liu X.L.,and Yan S.X.,2016,Effect of psychological intervention on the treatment of oral lichen planus,Guoji Kouqiang Yixue Zazhi(International Journal of Stomatology),43(1):22-25(周毅,孙秀荣,刘学丽,闫世霞,2016,心理干预对口腔扁平苔藓治疗效果的影响,国际口腔医学杂志,43(1):22-25)