中西医结合临床护理路径在急性非静脉曲张性上消化道出血中的应用价值

肖怀芳　李倩

【摘要】 目的 探討中西医结合临床护理路径在急性非静脉曲张性上消化道出血 （ANVUGIB）中的应用效果。方法 72例急性非静脉曲张性上消化道出血患者为研究对象， 按就诊顺序分为对照组和观察组， 各36例。对照组采用中西医结合治疗+常规临床护理方法， 观察组采用中西医结合治疗+中西医结合临床护理路径。比较两组患者的治疗效果、住院时间、治疗依从性和护理满意度。

结果 观察组总有效率97.22%高于对照组的80.56%， 差异具有统计学意义（χ2=5.063， P=0.024<0.05）。观察组住院时间为（9.2±2.5）d， 短于对照组的（11.9±2.7）d， 差异具有统计学意义 （P<0.05）。观察组治疗依从性100.00%高于对照组的86.11%， 差异具有统计学意义（χ2=5.373， P=0.020<0.05）。观察组护理满意度97.22%高于对照组的83.33%， 差异具有统计学意义（χ2=3.956， P=0.047<0.05）。结论 中西医结合临床护理路径的应用为急性非静脉曲张性上消化道出血患者提供了全方位的高质量护理， 提高了护理满意度， 使患者保持乐观情绪， 促进止血， 提高治疗效果。

【关键词】 中西医结合临床护理路径;急性非静脉曲张性上消化道出血;情志护理;饮食调护

DOI：10.14163/j.cnki.11-5547/r.2019.16.085

Application value of clinical nursing pathway of integrated traditional Chinese and Western medicine in acute non-variceal upper gastrointestinal hemorrhage   XIAO Huai-fang， LI Qian. Department of Gastroenterology， Chongqing Hospital of Traditional Chinese Medicine， Chongqing 400021， China

【Abstract】 Objective   To discuss the application value of clinical nursing pathway of integrated traditional Chinese and Western medicine in acute non-variceal upper gastrointestinal hemorrhage （ANVUGIB）. Methods   A total of 72 patients with acute non-variceal upper gastrointestinal hemorrhage as study subjects were divided by visiting order into control group and observation group， with 36 cases in each group. The control group received integrated traditional Chinese and Western medicine + routine clinical nursing， and the observation group received integrated traditional Chinese and Western medicine + integrated traditional Chinese and Western medicine clinical nursing pathway. Comparison were made on treatment effect， hospitalization time， treatment compliance and nursing satisfaction between the two groups. Results   The observation group had higher total effective rate as 97.22% than 80.56% in the control group， and the difference was statistically significant （χ2=5.063， P=0.024<0.05）. The observation group had shorter hospitalization time as （9.2±2.5） d than （11.9±

2.7） d in the control group， and the difference was statistically significant （P<0.05）. The observation group had higher treatment compliance as 100.00% than 86.11% in the control group， and the difference was statistically significant （χ2=5.373， P=0.020<0.05）. The observation group had higher nursing satisfaction as 97.22% than 83.33% in the control group， and the difference was statistically significant （χ2=3.956， P=0.047<0.05）. Conclusion   The application of integrated traditional Chinese and Western medicine clinical nursing pathway provides comprehensive and high-quality nursing for patients with acute non-variceal upper gastrointestinal bleeding， improves nursing satisfaction， keeps patients optimistic， promotes hemostasis and improves treatment effect.

【Key words】 Clinical nursing pathway of integrated traditional Chinese and Western medicine; Acute non-variceal upper gastrointestinal hemorrhage; Emotional nursing; Dietary nursing

急性非静脉曲张性上消化道出血是屈式韧带以上消化道及周边区域发生的出血疾病[1， 2]， 是常见的急危重症， 死亡率为6%～10%。随着质子泵抑制剂的应用以及中西医结合疗法的应用， 急性非静脉曲张性上消化道出血的治疗效果明显提高。而在治疗期间良好的护理服务有利于提高治疗效果， 本院对患者应用中西医结合临床护理路径， 现汇报如下。

1 资料与方法

1. 1 一般资料 选取本院2017年3月～2018年11月确诊并入院治疗的急性非静脉曲张性上消化道出血患者72例为研究对象， 均符合西医学和中医诊断标准， 发病48 h内入院， 年龄21～78岁， 排除合并肝肾、造血系统、内分泌系统疾病者以及骨关节病、精神病患者， 排除由消化道腫瘤引起出血患者， 排除需立即行外科手术或介入治疗患者， 排除妊娠期、哺乳期女性患者。按就诊顺序分为对照组及观察组， 各36例。……