CAJ | 학술논문

目的：初步探讨高血压脑出血术后合并上消化道出血的针对性护理对出血的预防和治疗作用。方法将2008年6月~2011年11月收治的需急诊手术的高血压脑出血患者随机分为对照组和实验组。对照组给予常规护理，实验组给予针对并发上消化道出血的预防性和治疗性护理，比较两组上消化道出血的发生率和好转情况。结果实验组入组49，并发上消化道出血8例，发病率为16.3%；对照组入组48例，并发上消化道出血18例，发病率为37.5%，两组发病率有统计学差异，P<0.05。实验组8例上消化道出血患者中，最终病情好转7例，好转率87.5%；对照组18例上消化道出血患者中，最终病情好转8例，好转率44.4%，两组患者好转率有统计学差异，P<0.05。结论对于高血压性脑出血患者，采取尽早抑酸、早期停留胃管、尽快恢复肠内营养以及积极开展心理辅导等针对性护理，不仅能有效预防应激性上消化道出血的发生，而且对于改善合并出血患者的预后有着积极的作用。
목적：초보탐토고혈압뇌출혈술후합병상소화도출혈적침대성호리대출혈적예방화치료작용。방법장2008년6월~2011년11월수치적수급진수술적고혈압뇌출혈환자수궤분위대조조화실험조。대조조급여상규호리，실험조급여침대병발상소화도출혈적예방성화치료성호리，비교량조상소화도출혈적발생솔화호전정황。결과실험조입조49，병발상소화도출혈8례，발병솔위16.3%；대조조입조48례，병발상소화도출혈18례，발병솔위37.5%，량조발병솔유통계학차이，P<0.05。실험조8례상소화도출혈환자중，최종병정호전7례，호전솔87.5%；대조조18례상소화도출혈환자중，최종병정호전8례，호전솔44.4%，량조환자호전솔유통계학차이，P<0.05。결론대우고혈압성뇌출혈환자，채취진조억산、조기정류위관、진쾌회복장내영양이급적겁개전심리보도등침대성호리，불부능유효예방응격성상소화도출혈적발생，이차대우개선합병출혈환자적예후유착적겁적작용。
Objective:to explore the prevention and treatment ef ect of pertinent nursing for upper gastrointestinal bleeding after operation on hypertensive cerebral hemorrhage. Methods:patients suf ering from hypertensive cerebral hemorrhage and receiving an craniotomy operation from Jun 2008 to Nov 2011 were divided into control and experiment groups. Routine nursing was given to the former, and the lat er received pertinent nursing for upper gastrointestinal bleeding after operation. The incidence rate of upper gastrointestinal bleeding and improvement of patients between two groups were compared. Results Forty-nine Patients were involved into experiment group, of which 8 cases of upper gastrointestinal bleeding happened; 48 Patients were involved into control group, of which 18 cases of upper gastrointestinal bleeding happened. The incidence rate was increased from 16.3%in experiment group to 37.5%in control group significantly (p<0.05). Seven of 8 upper gastrointestinal bleeding patients got improvement in experiment group comparing to 8 of 18 in control group, the improvement rate was decreased from 87.5%in experiment group to 44. 4% in control group significantly (p<0.05). Conclusions: the pertinent nursing for upper gastrointestinal bleeding containing early acid-reducing, stomach tubing, resuming enteral nutrition and psychological service can not only prevent bleeding, but also improve outcome.