摘要
目的:探讨重症急性胰腺炎(severe acute pancreatitis,SAP)并发多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的危险因素及护理策略.方法:收集并分析重症急性胰腺炎患者134例的临床资料,根据是否并发MODS,将患者分为2组,即并发MODS组和无MODS组,经Logistic回归分析SAP并发MODS的危险因素及2组患者的预后情况,总结SAP并发MODS患者的护理策略.结果:经Logistic回归分析结果,休克、胆道梗阻、高脂血症、低氧血症、肺部感染、胸腔积液、腹腔室隔综合征及Ranson评分、A PA C H EⅡ评分、C T评分的O R值分别为1.193、1.016、1.004、1.007、1.049、1.055、1.081、1.100、1.027,这些因素均是SAP并发MODS的独立危险因素(P<0.05).针对SAP并发MODS患者的护理,要重点监测患者的生命体征变化,加强呼吸功能、肾功能、凝血功能、肠功能的护理管理.结论:对SAP并发MODS的危险因素要提高警惕性,积极干预以改善患者的预后,并加强SAP并发MODS患者的护理管理,以降低死亡率.
AIM： To explore the risk factors and nursing strategies for severe acute pancreatitis （SAP） complicated with multiple organ dysfunction syndrome （MODS）. METHODS： Clinical data for 134 patients with SAP were retrospectively analyzed. Based on the presence of MODS or not, the patients were di- vided into two groups, those complicated with or without MODS. Risk factors and nursing strate- gies for SAP with MODS were then analyzed. RESULTS： Logistic regression analysis demon-strated that shock, biliary obstruction, hyper- lipidemia, hypoxemia, lung infection, pleural effusion, abdominal cavity room partition syn- drome and Ranson＇s score, APACHE II score, and CT score were independent risk factors for SAP complicated with MODS （OR = 1.193, 1.016, 1.004, 1.193, 1.049, 1.055, 1.081, 1.100, 1.027, all P 〈 0.05）. Nursing for SAP with MODS should focus on monitoring the patient＇s vital signs and strengthening the management of respiratory function, renal function, blood coagulation func- tion and intestinal function. CONCLUSION： Awareness of risk factors for SAP complicated with MODS should be raised to conduct active intervention to improve prog- nosis. Optimization of nursing management of SAP complicated with MODS can help reduce mortality.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第24期2456-2460,共5页
World Chinese Journal of Digestology
