黄福娣 邓娟 罗春霞

【摘要】 目的：探讨集束化护理联合早期肠内营养支持对SAP患者康复预后的影响。方法：选择2018年1月-2019年1月笔者所在医院诊断为SAP患者80例，随机分为对照组和观察组，各40例。两组均接受常规对症治疗及早期肠内营养支持，在此基础上，对照组采用常规专科护理方法，观察组采用集束化护理干预措施。比较两组APACHE Ⅱ评分、临床疗效、并发症发生率、康复时间和护理满意度。结果：观察组干预后APACHE Ⅱ評分为（5.3±1.2）分，低于对照组的（8.9±1.4）分，差异有统计学意义（P<0.05）;观察组并发症发生率为5.0%，低于对照组的20.0%，差异有统计学意义（P<0.05）;观察组护理满意度为95.0%，高于对照组的77.5%，差异有统计学意义（P<0.05）;观察组总有效率为97.5%，高于对照组的80.0%，差异有统计学意义（P<0.05）;观察组血淀粉酶恢复时间[（5.3±1.4）d]、腹痛缓解时间[（7.2±1.6）d]、尿淀粉酶恢复时间[（9.5±1.2）d]、住院时间[（15.6±2.4）d]均明显短于对照组[（7.5±1.8）、（12.4±3.9）、（19.6±5.8）、（26.1±6.7）d]，差异均有统计学意义（P<0.05）。结论：集束化护理结合早期肠内营养支持在SAP患者康复预后中具有重要的应用价值，能够有效提升患者的临床疗效，缩短康复时间，有效改善患者急性生理和慢性健康状态，护理满意度较高，值得推广。

【关键词】 集束化护理 肠内营养 重症急性胰腺炎

doi：10.14033/j.cnki.cfmr.2019.29.039 文献标识码 B 文章编号 1674-6805（2019）29-00-03

[Abstract] Objective： To investigate the effect of cluster nursing combined with early enteral nutrition support on rehabilitation prognosis of patients with SAP. Method： From January 2018 to January 2019， a total of 80 patients diagnosed with SAP in our hospital were randomly divided into the control group and the observation group， 40 cases in each group. Both groups received routine symptomatic treatment and early enteral nutrition support. On this basis， the control group was treated with routine specialized nursing method， and the observation group was treated with cluster nursing intervention. The APACHE Ⅱ score， clinical efficacy， incidence of complications， rehabilitation time and nursing satisfaction were compared between the two groups. Result： After intervention， the APACHE Ⅱ score of the observation group was （5.3±1.2） points， which was lower than （8.9±1.4） points of the control group， and the difference was statistically significant （P<0.05）. The incidence of complications of the observation group was 5.0%， which was lower than 20.0% of the control group， and the difference was statistically significant （P<0.05）. The nursing satisfaction of the observation group was 95.0%， which was higher than 77.5% of the control group， and the difference was statistically significant （P<0.05）. The total effective rate in the observation group was 97.5%， which was higher than 80.0% of the control group， and the difference was statistically significant （P<0.05）. Blood amylase recovery time [（5.3±1.4） d]， abdominal pain relief time [（7.2±1.6） d]， urine amylase recovery time [（9.5±1.2） d]， and hospital stay time [（15.6±2.4） d] in the observation group were significantly shorter than those of the control group [（7.5±1.8）， （12.4±3.9）， （19.6±5.8），  （26.1±6.7） d]， and the differences were statistically significant （P<0.05）. Conclusion： Cluster nursing combined with early enteral nutrition support has an important application value in the rehabilitation prognosis of SAP patients. It can effectively improve the clinical efficacy of SAP patients， and shorten the recovery time. It can effectively improve the acute physiological and chronic health status of patients， and the nursing satisfaction is high， which is worth promoting.

[Key words] Cluster nursing Enteral nutrition Severe acute pancreatitis

First-authors address： The Second Hospital of Sanming， Yongan 366000， China

急性胰腺炎（acute pancreatitis，AP）是較常见的急腹症，具有起病快、病情复杂、并发症发生率和死亡率高的特点。重症急性胰腺炎（severe acute pancreatitis，SAP）易继发感染、休克、多器官功能障碍综合征等并发症，发病72 h内行综合内科治疗可阻止病情进展，改善临床预后[1]。早期积极纠正肠内营养障碍对促进疾病康复具有重要意义。由于患者早期生命体征不稳定，肠道功能紊乱，如何促进肠内营养有效吸收是治疗的关键。科学、安全的护理管理是临床治疗的重要组成部分[2]。集束化护理是指集合一系列具有循证基础的治疗和护理措施，用来针对性处理某一类疾病。在严格执行各项护理措施过程中，不能间断或选择性的应用某一项或几项，体现集束化护理的整体性和连贯性。本次研究旨在探讨集束化护理联合早期肠内营养支持对SAP患者康复预后的影响，报道如下。

1 资料与方法