急性上消化道出血采取危险性评估的针对性护理效果
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摘要
目的:评价采取危险性评估的针对性护理在急性上消化道出血护理过程中的效果。方法:选择2015年1月至2016年1月间急诊就诊的88例急性上消化道出血患者为研究对象,随机分为观察组和对照组,每组44例,对照组患者采用常规护理模式,观察组患者采用危险性评估的针对性护理模式,比较两组患者的再出血率和再出血次数,1年死亡率,输血率,住院时间和治疗满意度。结果:观察组患者中危险性出血的再出血率低于对照组(χ~2=4.539,P=0.033),再出血次数均低于对照组(t_(一般)=3.865,P_(一般)=0.043;t_(危险)=3.991,P_(危险)=0.047);观察组患者中危险性出血的输血率低于对照组(χ~2=3.955,P=0.046);观察组患者中危险性出血的1年死亡率低于对照组(χ~2=4.125,P=0.042);观察组患者的住院时间低于对照组(t_(一般)=3.752,P_(一般)=0.000;t_(危险)=3.746,P_(危险)=0.000),治疗满意度高于对照组(t_(一般)=3.329,P_(一般)=0.001;t_(危险)=4.735,P_(危险)=0.000)。结论:在急性上消化道出血护理过程中采用危险性评估的针对性护理模式可以降低患者的再出血率和再出血次数,减少输血率,降低住院时间和死亡率,具有较高的治疗满意度,值得推广。
Objective: To observe the efficacy of targeted nursing model based on risk assessment on the acute upper gastrointestinal bleeding.Methods: 88 cases of patients with acute upper gastrointestinal bleeding from January 2015 to January 2016 were randomly divided into experimental and control group,44 cases in each group. The control group was treated with conventional nursing model and the experimental group was treated with targeted nursing model based on risk assessment. The rebleeding rate,the number of rebleeding,1-year mortality,one year mortality,blood transfusion rate,hospital stay and treatment satisfaction were comparatively analyzed. Results: The dangerous rebleeding rate in experimental group was lower than that in control group( χ~2= 4. 539,P = 0. 033). The number of rebleeding in experimental group was lower than that in control group( tgeneral= 3. 865,Pgeneral= 0. 043; tdangerous= 3. 991,Pdangerous= 0. 047). The dangerous blood transfusion rate in experimental group was lower than that in control group( χ~2= 3. 955,P = 0. 046). The one year mortality of dangerous bleeding in experimental group was lower than that in control group( χ~2= 4. 125,P = 0. 042). The hospital stay in experimental group was obviously lower than that in control group( t_(general)= 3.752,P_(general)= 0. 000; t_(dangerous)= 3. 746,P_(dangerous)= 0. 000). The patients' satisfaction rate in experimental group was significantly higher than that in control group( t_(general)= 3. 329,P_(general)= 0. 001; t_(dangerous)= 4. 735,P_(dangerous)= 0. 000). Conclusions: Targeted nursing model based on risk assessment for the acute upper gastrointestinal bleeding can obviously lower the rebleeding rate and the number of rebleeding,significantly reduce the mortality,blood transfusion rate and hospital stay,and remarkably improve the patients' satisfaction rate. It is worthy of promotion.
Objective: To observe the efficacy of targeted nursing model based on risk assessment on the acute upper gastrointestinal bleeding.Methods: 88 cases of patients with acute upper gastrointestinal bleeding from January 2015 to January 2016 were randomly divided into experimental and control group,44 cases in each group. The control group was treated with conventional nursing model and the experimental group was treated with targeted nursing model based on risk assessment. The rebleeding rate,the number of rebleeding,1-year mortality,one year mortality,blood transfusion rate,hospital stay and treatment satisfaction were comparatively analyzed. Results: The dangerous rebleeding rate in experimental group was lower than that in control group( χ~2= 4. 539,P = 0. 033). The number of rebleeding in experimental group was lower than that in control group( tgeneral= 3. 865,Pgeneral= 0. 043; tdangerous= 3. 991,Pdangerous= 0. 047). The dangerous blood transfusion rate in experimental group was lower than that in control group( χ~2= 3. 955,P = 0. 046). The one year mortality of dangerous bleeding in experimental group was lower than that in control group( χ~2= 4. 125,P = 0. 042). The hospital stay in experimental group was obviously lower than that in control group( t_(general)= 3.752,P_(general)= 0. 000; t_(dangerous)= 3. 746,P_(dangerous)= 0. 000). The patients' satisfaction rate in experimental group was significantly higher than that in control group( t_(general)= 3. 329,P_(general)= 0. 001; t_(dangerous)= 4. 735,P_(dangerous)= 0. 000). Conclusions: Targeted nursing model based on risk assessment for the acute upper gastrointestinal bleeding can obviously lower the rebleeding rate and the number of rebleeding,significantly reduce the mortality,blood transfusion rate and hospital stay,and remarkably improve the patients' satisfaction rate. It is worthy of promotion.
引文
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[3]冯明丽,徐丽君,田继云,等.Rockall和Blatchford评分系统对急性非静脉曲张性上消化道出血的风险评价比较[J].胃肠病学,2017,22(2):96-99.
[4]谭炜,戈之铮,高云杰,等.不明原因消化道出血患者临床再出血危险因素分析[J].中华消化内镜杂志,2012,29(11):604-608.
[5]谢林,艾敏,沈薇.1329例上消化道出血病因分析及风险评估[J].重庆医学,2014,43(25):3336-3338.
[6]中华内科杂志社,中华医学杂志社,中华消化杂志社,等.急性非静脉曲张性上消化道出血诊治指南(2015年,南昌)[J].中华消化杂志,2015,35(12):793-798.