欧阳红莲 练巧兰 冯维燕 邓林娜

[摘要] 目的 探討中医综合护理干预在严重脓毒症胃肠功能障碍患者中的效果。 方法 选取2016年11月～2017年8月广州中医药大学第二附属医院ICU收治的80例严重脓毒症胃肠功能障碍患者，按照随机数字表法分为常规组和综合组，每组各40例。常规组患者采取院内常规护理，综合组患者在常规护理的基础上给予中医综合护理干预，比较两组患者临床干预改善效果和影响。 结果 两组患者第1、3天的APACHE-Ⅱ评分差异无统计学意义（P > 0.05），随着治疗时间延长APACHE-Ⅱ评分下降明显，其第7天的APACHE-Ⅱ评分综合组明显优于常规组，差异有统计学意义（P < 0.05）。两组干预前的舒适度评分、睡眠质量指数比较，差异无统计学意义（P > 0.05），干预后综合组舒适度评分、睡眠质量指数均优于常规组，差异有统计学意义（P < 0.05）；干预前两组胃肠黏膜内pH值、腹腔压力比较，差异无统计学意义（P > 0.05），干预后综合组胃肠黏膜内pH值、腹腔压力均优于常规组，差异有统计学意义（P < 0.05）。综合组患者护理后在ICU住院时间、总住院时间、住院费用等明显少于常规组，差异有统计学意义（P < 0.05）。干预后综合组的胃肠功能改善总有效率高于常规组，差异有统计学意义（P < 0.05）。 结论 患者在经过中医综合护理干预后治疗效果显著提升，患者对治疗的满意程度提高，腹内压、胃酸pH值、胃肠功能恢复到正常水平之内，有利于减轻其经济负担，值得进行临床推广和应用。

[关键词] 严重脓毒症；胃肠功能障碍；护理

[中图分类号] R246.1 [文献标识码] A [文章编号] 1673-7210（2018）05（b）-0124-05

Influence of traditional Chinese medicine comprehensive nursing intervention on patients with severe sepsis and gastrointestinal dysfunction

OUYANG Honglian LIAN Qiaolan FENG Weiyan DENG Linna

ICU， Guangdong Chinese Medicine Hospital Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine， Guangdong Province， Guangzhou 510120， China

[Abstract] Objective To investigate the effect of traditional Chinese medicine comprehensive nursing on severe sepsis patients with gastrointestinal dysfunction. Methods From November 2016 to August 2017， in ICU， Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine， 80 severe sepsis patients with gastrointestinal dysfunction were selected， and they were divided into convention group and comprehensive group according to the random number table method， with 40 cases in each group. Conventional nursing was applied to the patients in the convention group， and the comprehensive nursing was applied to the comprehensive group on the basis of conventional nursing. The effect and influence of clinical intervention on patients of the two groups were compared. Results There was no statistically significant difference in APACHE-Ⅱ scores of two groups on 1st， 3rd day （P > 0.05）， and the APACHE-Ⅱ scores decreased significantly with the prolongation of treatment time， on 7th day APACHE-Ⅱ scores of comprehensive group was significantly better than that of the convention group， and the difference was statistically significant （P < 0.05）. There was no statistically significant difference in the comfort score and sleep quality index of the two groups before intervention （P > 0.05）， and after intervention， the comfort score and sleep quality index in the comprehensive group were better than those in the convention group， and the differences were statistically significant （P < 0.05）. There was no statistically significant difference in pH and abdominal pressure of two groups before intervention （P > 0.05）， after intervention， the pH and abdominal pressure of gastrointestinal mucosa in the comprehensive group were better than those in the convention group， the differences were statistically significant （P < 0.05）. The hospitalization time， total hospitalization time and hospitalization expenses of the patients in the comprehensive group were less than those in the convention group， the differences were statistically significant （P < 0.05）. After intervention， the total effective rate of gastrointestinal function improvement in the comprehensive group were higher than that in the convention group， the difference was statistically significant （P < 0.05）. Conclusion After the intervention of traditional Chinese medicine， the clinical effect of patients significantly is improved， and the satisfaction degree of patients is improved. the intra-abdominal pressure， gastric acid pH and gastrointestinal function returnes to normal level， it is helpful to reduce their economic burden， and it is worthy of clinical promotion and application.

[Key words] Severe Sepsis； Gastrointestinal dysfunction； Nursing

严重脓毒症因其高发病率和高病死率而严重危害人类的生命健康，给国家和社会带来了巨大的财力和人力负担[1]。目前，国际上对严重脓毒症的防治研究已成为医疗卫生领域常见的重大疑难疾病。脓毒症是指由于各种致病微生物或是其他毒素存在于人体的血液或是身体组织中，致使人体机体感染的一种不可控的全身炎症的反应。胃肠功能障碍在危重症患者病情演变中扮演了重要的角色，如何促进严重脓毒症患者胃肠功能的恢复已成为危重病领域的热点研究问题，而护理对于严重脓毒症胃肠功能障碍患者的转归和预后是密不可分的[2]。虽……