摘要
目的研究目标导向护理对脓毒症患者循环功能及肠道菌群的影响。方法选取2017年6月至2019年6月诊治的147例脓毒症患者,按随机法分为观察组(n=72)和对照组(n=75),观察组行目标导向护理,对照组行常规护理。观察2组健康情况、器官功能衰竭评分、肠道菌群、循环功能、氧合功能、肾功能、护理质量、生存情况。结果2组患者护理后的健康情况、器官功能衰竭评分低于护理前(P<0.05);观察组患者健康情况、器官功能衰竭评分低于对照组(P<0.05);观察组患者双歧杆菌高于对照组,且肠杆菌、肠球菌、类杆菌、专性厌氧菌、假单胞菌、葡萄球菌低于对照组(P<0.05);2组患者中心静脉血氧饱和度(ScvO2)、中心动脉压、平均动脉压、动脉血氧分压(PaO2)、尿量高于护理前,且心率、血肌酐低于护理前(P<0.05);观察组患者ScvO2、中心动脉压、平均动脉压、PaO2、尿量高于对照组,心率、血肌酐低于对照组(P<0.05);观察组出现人工气管非计划内拔管1例(1.39%)、呼吸机相关肺炎8例(11.11%)、胃管非计划内拔管4例(5.56%)、执行医嘱延时1例(1.39%);对照组人工气管非计划内拔管10例(13.33%)、呼吸机相关肺炎24例(32.00%)、胃管非计划内拔管21例(28.00%)、执行医嘱延时9例(12.00%);对照组护理质量低于观察组(P<0.05);观察组患者生存率为72.22%高于对照组的42.67%(P<0.05)。结论目标导向护理可改善脓毒症患者的循环功能与肠道菌群,值得临床广泛应用。
Objective To investigate the effects of goal-oriented nursing on the circulatory function and intestinal flora of patients with sepsis.Methods A total of 147 patients with sepsis who were diagnosed and treated in our hospital from June 2017 to June 2019 were enrolled in the study,who were randomly divided into observation group(n=72)and control group(n=75).The patients in observation group were treated by goal-oriented nursing,however,the patients in control group were treated by routine nursing.The health status,organ failure score,intestinal flora,circulatory function,oxygenation function,renal function,quality of nursing,and survival rate were observed and compared between the two groups.Results After nursing,the scores of health status and organ failure in both groups were significantly decreased(P<0.05),moreover,which in observation group were significantly lower than those in control group(P<0.05).And the Bifidobacterium numbers in observation group were significantly higher than those in control group,however,the numbers of Enterobacteriaceae,Enterococcus,Bacteroides,obligate anaerobe,Pseudomonas,and Staphylococcus were significantly lower than those in control group(P<0.05).After nursing,the ScvO2,central arterial pressure,mean arterial pressure,PaO2,and urine volume in both groups were significantly increased,however,the heart rate and serum creatinine levels were significantly decreased,moreover,the changes in observation group were more significant than those in control group(P<0.05).In observation group,there was 1 case(1.39%)of unplanned artificial tracheal tube extubation,8 cases(11.11%)of ventilators associated pneumonia,4 cases(5.56%)of unplanned gastric tube extubation,and 1 case(1.39%)of delayed execution of doctor’s orders,on contrast of those,which in control group were 10 cases(13.33%),24 cases(32.00%),21 cases(28.00%)and 9 cases(12.00%),respectively.The nursing quality in control group was significantly lower than that in observation group(P<0.05).And the survival rate of patients in obser
作者
赵丽
吴瑶
田姗
ZHAO Li;WU Yao;TIAN Shan(Department of Emergency,The Second Affiliated Hospital of Xi’an Jiaotong University,Shanxi,Xi’an 710004,China;不详)
出处
《河北医药》
CAS
2021年第17期2704-2708,共5页
Hebei Medical Journal
关键词
目标导向护理
脓毒症
循环功能
肠道菌群
goal-oriented nursing
sepsis
circulatory function
intestinal flora
