张萍 刘宝存

【摘要】 目的：觀察在多器官功能衰竭患者管道护理中采取集束化护理的临床效果。方法：选取2015年1月-2016年12月多器官功能衰竭患者57例为研究对象，采取常规护理干预，设置为对照组。2017年1月笔者所在医院开展集束化护理干预，应用于2017年1月-2018年12月收治的63例多器官功能衰竭患者多管道护理中，设置为集束组。对比两组并发症发生率、全科医学科治疗时间、干预前后PSQI评分。结果：两组护理前PSQI评分比较，差异均无统计学意义（P>0.05）。护理后两组PSQI各项评分均较护理前下降，集束组下降幅度较对照组更明显，差异均有统计学意义（P<0.05）。集束组并发症发生率为3.18%，明显低于对照组的17.54%，差异有统计学意义（P<0.01）。集束组全科医学科治疗时间明显短于对照组，差异有统计学意义（P<0.01）。结论：在多器官功能衰竭患者多管道护理中，采取集束化护理干预可明显改善患者睡眠质量，降低并发症发生率，减少治疗时间，效果理想。

【关键词】 集束化护理; 多器官功能衰竭; 管道护理; 临床疗效

doi：10.14033/j.cnki.cfmr.2019.27.052 文献标识码 B 文章编号 1674-6805（2019）27-0-03

Clinical Effect of Cluster Nursing in Pipeline Nursing of Patients with Multiple Organ Failure/ZHANG Ping，LIU Baocun.//Chinese and Foreign Medical Research，2019，17（27）：-122

【Abstract】 Objective：To observe the clinical effect of cluster nursing in pipeline nursing of patients with multiple organ failure.Method：A total of 57 patients with multiple organ failure from January 2015 to December 2016 were selected as research objects，and routine nursing intervention was adopted as the control group.Cluster nursing intervention was carried out in our hospital in January 2017，which was applied in multi-channel nursing of 63 patients with multiple organ failure admitted from January 2017 to December 2018 and set as the cluster group.Complication rate，Emergency General Medicine Department treatment time and PSQI scores before and after intervention were compared between the two groups.Result：Before nursing，PSQI scores were compared between the two groups，and the differences were not statistically significant（P>0.05）.After nursing，the scores of PSQI in the two groups decreased compared with those before nursing，and the scores of PSQI in the cluster group were significantly lower than those of the control group（P<0.05）.The incidence of complications in the cluster group was 3.18%，which was significantly less than that of the control group（17.54%），the difference was statistically significant（P<0.01）.And the Emergency General Medicine Department treatment time in the cluster group was significantly shorter than that of the control group，the difference was statistically significant（P<0.01）.Conclusion：In multi-channel nursing for patients with multiple organ failure，cluster nursing intervention can significantly improve the sleep quality of patients，reduce the incidence of complications，and reduce the treatment time，and the effect is ideal.

【Key words】 Cluster nursing; Multiple organ failure; Pipeline nursing; Clinical effect

First-authors address：The First Affiliated Hospital of Sun Yat-sen University，Guangzhou 510080，China

多器官功能衰竭（multiple organ failure，MOF）诊断标准及概念在1977年被Eisemand提出，属于临床常见急危重症之一[1]。MOF指患者在创伤、严重感染、大手术及病理产科等应激状况下同时出现多个器官功能衰竭的现象，预后效果较差[2]。临床需要密切监护MOF患者，在充分了解病情的同时需积极进行支持治疗[3]。在治疗过程中，针对不同器官需要使用不同仪器，仪器与机体间的连接需要采取管道连接。在多管道连接后，患者常处于被动体位而不能得到充分休息，极易引发多种并发症，此时需要采取针对性的护理干预措施[4-5]。针对临床护理问题，以循证理论为基础，为患者提供优质、连续性、集合化管理护理服务称为集束化护理[6]。2017年1月笔者所在医院开展集束化护理干预，应用于2017年1月-2018年12月收治的63例多器官功能衰竭患者多管道护理中，效果总结如下。