摘要
目的:探讨 6 h复苏目标理论为导向的护理干预对脓毒症患者的影响.方法:选取 2020 年 1 月 1 日～2022 年 12 月 31日收治的 107 例脓毒症患者为研究对象,采用随机数字表法分为研究组 54 例和对照组 53 例,对照组采用常规护理,研究组在常规护理基础上联合 6 h复苏目标理论为导向的护理干预;比较两组干预前后氧合功能[包括动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、中心静脉血氧饱和度(ScvO2)、氧合指数(PaO2/FiO2)]、循环功能[包括心率(HR)、动脉血乳酸(Lac)、平均动脉压(MAP)、中心静脉压(CVP)]、肾功能[包括血清血肌酐(Scr)、尿素氮(BUN)及尿量]、恢复情况及生活质量[采用健康调查简表(SF-36)],意外发生情况.结果:干预后,两组CVP、MAP、PaO2/FiO2、PaO2、ScvO2、PaCO2 水平、SF-36 评分均高于干预前(P<0.05),且研究组高于对照组(P<0.05,P<0.01);干预后,两组Lac、HR、血清Scr、BUN水平、尿量、6 个系统(心血管、血液、肾脏、神经、肝脏、呼吸)评分均优于干预前(P<0.05),且研究组优于对照组(P<0.01);研究组执行医嘱延时、人工气管计划外拔管、胃管计划外拔管、呼吸机相关性肺炎发生率均低于对照组(P<0.05).结论:6 h复苏目标理论为导向的护理干预能改善脓毒症患者氧合、循环及肾功能,提高恢复情况、生活质量.
Abstract
Objective:To explore the effect of 6-hour resuscitation goal-oriented nursing intervention on patients with sepsis.Methods:107 patients with sepsis admitted from January 1,2020 to December 31,2022 were selected as the study objects,and were divided into study group(54 cases)and control group(53 cases)by random number table method.The control group received routine nursing care and the study group was provided 6-hour resuscitation goal-oriented nursing intervention based on routine nursing care.Oxygenation function in-cluding arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),central venous oxygen saturation(ScvO2),oxygenation index(PaO2/FiO2),circulation function including heart rate(HR),arterial lactic acid(Lac),mean arterial pressure(MAP),central venous pressure(CV),kidney function including serum creatinine(Scr),urea nitrogen(BUN),and urine volum,recovery and qual-ity of life(SF-36),survival rate,quality of care were compared between the two groups before and after intervention.Results:After inter-vention,the levels of CVP,MAP,PaO2/FiO2,PaO2,ScvO2,PaCO2 and SF-36 scores in both groups were higher than those before interven-tion(P<0.05),and they were higher in the study group than those in the control group(P<0.05,P<0.01).After intervention,Lac,HR,Scr,BUN level,urine volume,6 systems(cardiovascular,blood,kidney,nerve,liver,respiratory)scores in both groups were better than those before intervention(P<0.05),and the scores in the study group were better than those in the control group(P<0.01).The incidence of delayed execution of medical orders,unscheduled extubation of artificial trachea and gastric tube,and ventilator-related pneumonia in the study group were lower than those in the control group(P<0.05).Conclusion:6-hour resuscitation goal-oriented nursing intervention can improve oxygenation,circulation and renal function,and improve recovery and quality of life in patients with sepsis.
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