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规范化营养护理流程在重症急性胰腺炎患者中的应用效果分析

Effects of standardized nutritional nursing process in severe acute pancreatitis patients
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摘要 目的探讨规范化营养护理流程在重症急性胰腺炎(SAP)患者中的应用效果。方法采用便利抽样法选择2015年1月—2016年6月浙江省人民医院/杭州医学院附属人民医院收治的85例SAP患者为对照组,2016年7月—2017年12月收治的88例SAP患者为观察组。两组均给予肠内营养,对照组采用常规营养护理,观察组采用规范化营养护理流程。比较两组患者喂养不耐受情况、喂养相关并发症、营养达标率、营养状况等的差异。结果观察组患者发生呕吐2例,腹胀10例,便秘5例,每日腹泻次数(2.4±0.6)次,腹内压升高5例,腹腔间室综合征1例,均低于对照组,两组比较差异有统计学意义(P<0.05)。喂养相关并发症发生率观察组低于对照组,差异有统计学意义(P<0.01)。入院7 d观察组营养达标率为89.8%,对照组为71.8%,差异有统计学意义(χ^2=8.083,P<0.01)。入院14 d时观察组患者前白蛋白、血清白蛋白、肱三头肌皮褶厚度、上臂肌围等营养状况指标均高于对照组,差异有统计学意义(P<0.05)。观察组ICU停留时间、机械通气比例、机械通气时间均低于对照组,差异有统计学意义(P<0.05)。结论SAP患者实施规范化营养护理流程能够减少喂养相关并发症及喂养不耐受情况,改善营养状况,值得在临床中推广应用。 Objective To explore the effects of standardized nutritional nursing process in severe acute pancreatitis(SAP)patients.Methods From January 2015 to June 2016,we selected 85 SAP patients at Zhejiang Province People's Hospital&People's Hospital of Hangzhou Medical College in control group by convenience sampling.From July 2016 to December 2017,we selected 88 SAP patients in observation group.Two groups all carried out enteral nutrition.Control group received routine nutritional nursing,while observation group implemented standardized nutritional nursing process.We compared the feeding intolerance,feeling related complications,standard-reaching rate of nutrition and nutritional status of patients between two groups.Results There were 2 cases with vomit,10 cases with abdominal distension,5 cases with constipation,all with diarrhea(2.4±0.6)times a day,5 cases with elevated intra-abdominal pressure and 1 case with abdominal compartment syndrome in observation group less than those in control group with statistical differences(P<0.05).The incidence of feeling related complications of observation group was lower than that of control group with a statistical difference(P<0.01).At the seventh day,the standard-reaching rate of nutrition of observation group and control group was 89.8%and 71.8%respectively with a statistical difference(χ^2=8.083,P<0.01).At the fourteenth day,the nutrition indicators such as prealbumin,serum albumin,triceps skin-fold thickness and arm muscle circumference of patients in observation group were higher than those in control group(P<0.05).The residence time in intensive care unit,proportion of mechanical ventilation and time of mechanical ventilation of observation group were statistically lower than those of control group(P<0.05).Conclusions The implementation of standardized nutritional nursing process in SAP patients can reduce the feeling related complications and feeding intolerance to improve nutritional status which is worth to be used widely in clinical application.
作者 富燕萍 王金柱 李莉莉 李飞 陈娟红 姚惠萍 Fu Yanping;Wang Jinzhu;Li Lili;Li Fei;Chen Juanhong;Yao Huiping(Intensive Care Unit,Zhejiang Province People's Hospital & People's Hospital of Hangzhou Medical College,Hangzhou 310014,China)
出处 《中华现代护理杂志》 2019年第12期1500-1505,共6页 Modern Nursing
基金 浙江省医药卫生科研面上项目(2018KY254).
关键词 胰腺炎 规范化营养护理流程 肠内营养 喂养不耐受 营养状况 Pancreatitis Standardized nutritional nursing process Enteral nutrition Feeding intolerance Nutritional status
作者简介 通信作者:姚惠萍,Email:linkimlin@163.com.
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