摘要
目的探究Rockall危险性积分评估下分级化干预在急性上消化道出血患者中的应用效果。方法选取南通市第二人民医院2020年4月~2022年5月消化内科收治的急性上消化道出血患者86例,随机数表法分为对照组和观察组,各43例。对照组实施常规干预措施,观察组Rockall危险性积分评估下分级化干预措施。于入院1 d、干预7 d,对两组心理状态、应激水平及并发生变化情况进行分析。结果与入院1 d相比,干预7 d后,两组心理复原能力改善情况提升显著,且观察组优于对照组,差异有统计学意义(P<0.05);入院1 d,两组应激水平差异无统计学意义(P>0.05);干预7 d后,与对照组相比,观察组在皮质醇(COR)、肿瘤坏死因子(TNF)等应激水平,改善明显,差异有统计学意义(P<0.05);观察组在再出血、营养不良、肝性脑病、休克等并发症发生下降明显,差异有统计学意义(P<0.05)。结论对急性上消化道出血患者实施Rockall危险性积分评估下分级化干预,可增强患者自身心理抵抗与承受能力,改善机体应激水平,降低并发症发生。
Objective To explore the application effect of hierarchical intervention under Rockall risk score assessment in patients with acute upper gastrointestinal bleeding.Methods A total of 86 patients with acute upper gastrointestinal bleeding admitted to the Department of Gastroenterology of the Second People's Hospital of Nantong from April 2020 to May 2022 were selected by random number allocation table method,a reference group and an intervention group.43 cases in the reference group received routine intervention,the intervention group of 43 cases of Rockall risk score assessment of hierarchical intervention.after 1 day of admission and 7 days of intervention,the psychological state,stress level and changes of the two groups were analyzed.Results Intra-group comparison:The improvement of psychological resilience in the two groups after 7 days of intervention,compared with one day after admission,the improvement was significant(P<0.05).Comparison between groups:Seven days after the intervention,compared with the reference group,the intervention group showed considerable improvement(P<0.05).One day after admission,comparison of stress levels between the two groups(P>0.05).After 7 days of intervention,in the intervention group,stress levels of cortisol(COR)and tumor necrosis factor(TNF)improved significantly(P<0.05).The incidence of complications such as rebleeding,malnutrition,hepatic encephalopathy and shock decreased significantly in the intervention group(P<0.05).Conclusions Graded intervention under Rockall risk score assessment was performed on patients with acute upper gastrointestinal bleeding admitted to our hospital to enhance their psychological resistance and endurance,improve the stress level of the body,and reduce the occurrence of complications.
作者
樊倩
马丽
吴丽
瞿芳
Fan Qian;Ma Li;Wu Li(Digestive Internal Medicine,Nantong Second People's Hospital,Nantong 226002,China)
出处
《中华保健医学杂志》
2023年第2期155-158,共4页
Chinese Journal of Health Care and Medicine
基金
江苏省中医药科研计划项目(YB2020015)。
