摘要
目的:探讨经鼻空肠营养管在急性重症胰腺炎的早期应用及护理方法，评价其护理效果。方法:选取解放军总医院第一医学中心消化内科医学部2020年6月至2022年10月期间收治的82例急性重症胰腺炎患者作为研究对象，分为观察组(综合护理干预)和对照组(常规护理)各41例，对比两组的护理效果。结果:观察组患者在护理后的血清白蛋白(ALB)水平(36.14±4.67)g/L>(31.48±5.09)g/L，t＝4.320、前白蛋白(PA)水平(221.89±11.08)mg/L>(192.07±13.57)mg/L，t＝10.889，高于对照组(P<0.05)。观察组患者在护理后的急性生理与慢性健康评分表(APACHE-Ⅱ)评分(13.37±2.95)分<(16.12±3.43)分，t＝4.607，低于对照组(P<0.05)。观察组患者在护理后的健康调查简表(SF-36)评分(68.43±5.10)分>(59.05±5.49)分，t＝8.015，高于对照组(P<0.05)。观察组患者的腹痛症状消失时间(3.04±0.86)d<(5.19±1.12)d，t＝9.749、肠鸣音恢复时间(1.77±0.50)d<(2.94±0.69)d，t＝8.792、肛门排气时间(3.47±1.13)d<(4.89±1.28)d，t＝5.325，比对照组更短(P<0.05)。观察组患者护理满意度95.12%>78.05%，χ2＝5.145，高于对照组(P<0.05)。观察组患者的并发症发生率4.88%<19.51%，χ2＝4.554，低于对照组(P<0.05)。结论:急性重症胰腺炎患者的康复过程中，早期应用经鼻空肠营养管，实施肠内营养支持干预，同时给予患者综合、全面的护理干预，可以更好的改善患者的营养状态，提高其生活质量，获得良好的预后。
Abstract
Objective:To explore the early application and nursing methods of nasal jejunal nutrition tube in acute severe pancreatitis, and evaluate its nursing effect.Methods:82 patients with acute severe pancreatitis admitted to the Department of Gastroenterology at the First Medical Centre of the Chinese PLA General Hospital from June 2020 to October 2022 were selected as the research subjects.They were divided into an observation group (comprehensive nursing intervention) and a control group (routine nursing), with 41 patients in each group. The nursing effects of the two groups were compared.Results:The serum albumin (ALB) levels of the observation group patients after nursing were (36.14 ± 4.67) g/L > (31.48 ± 5.09) g/L, t=4.320, and the prealbumin (PA) levels were (221.89 ± 11.08) mg/L > (192.07 ± 13.57) mg/L, t=10.889, which were higher than those of the control group (P<0.05). The acute physiology and chronic health score (APACHE-Ⅱ) of the observation group patients after nursing was (13.37±2.95) points less than (16.12±3.43) points, t=4.607, lower than that of the control group (P<0.05). The observation group patients′ health survey summary (SF-36) score after nursing was (68.43±5.10) points > (59.05 ±5.49) points, t=8.015, which was higher than that of the control group (P<0.05). The disappearance time of abdominal pain symptoms in the observation group was (3.04±0.86) d<(5.19±1.12) d, t=9.749, the recovery time of bowel sounds was (1.77±0.50) d<(2.94±0.69) d, t=8.792, and the anal exhaust time was (3.47±1.13) d<(4.89±1.28) d, t=5.325, which was shorter than the control group (P<0.05). The nursing satisfaction of patients in the observation group was 95.12% > 78.05%, χ2=5.145, higher than the control group (P<0.05). The incidence of complications in the observation group was 4.88% <19.51%, χ2=4.554, lower than the control group (P<0.05).Conclusion:In the rehabilitation process of patients with acute severe pancreatitis, early application of nasal jejunal nutrition tubes, implementation of enteral nutrition support interventions, and comprehensive nursing interventions can better improve the patient's nutritional status, improve their quality of life, and obtain good prognosis.
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