CAJ | 학술논문

目的探讨护理干预联合肠内营养对神经内科肠功能障碍患者预后的影响.方法选择2011年7月至2012年6月神经内科肠功能障碍的120例重症患者,将患者分为对照组58例与观察组62例,对照组进行肠内营养与常规护理,观察组在常规护理的基础上进行肠内营养的营养液输注与并发症护理.观察两组患者的病程、治愈率、病死率、后遗症以及并发症,并检测血清总蛋白(TP)、血清白蛋白(ALB)以及血清前蛋白(PA)的变化.结果观察组持续病程(55.2±8.3)d,明显短于对照组的(87.7±10.5)d,两组比较差异有统计学意义(t=-18.872,P＜0.05)；观察组治愈率为95.2％,对照组为6.2％,两组比较差异有统计学意义(x2=77.235,P＜0.05)；观察组病死1例(1.6％),后遗症6例(8.6％),明显低于对照组(5,13例),两组比较差异有统计学意义(x2=5.062,5.985；P＜0.05).观察组发生上消化道出血0例,电解质紊乱5例,肝肾功能损害2例,神经功能损害10例,与对照组比较(分别为9,16,10,23例),差异均有统计学意义(x2值分别为10.401,7.910,6.541,8.319;P ＜0.05).观察组治疗后TP、ALB、PA含量明显较治疗前提高,与对照组比较[(68.2±2.3)/(61.5±2.1)g/L,(36.8 ±2.1)/(31.7 ±2.0)g/L,(251.8±30.01)/(173.1±27.6)mg/L],差异具有统计学意义(t值分别为14.149,12.842,10.792;P ＜0.05).结论护理干预联合肠内营养科有效缩短患者病程,提高治愈率,降低病死率及并发症,并有效提高TP、ALB及PA的含量.
목적 탐토호리간예연합장내영양대신경내과장공능장애환자예후적영향.방법 선택2011년7월지2012년6월신경내과장공능장애적120례중증환자,장환자분위대조조58례여관찰조62례,대조조진행장내영양여상규호리,관찰조재상규호리적기출상진행장내영양적영양액수주여병발증호리.관찰량조환자적병정、치유솔、병사솔、후유증이급병발증,병검측혈청총단백(TP)、혈청백단백(ALB)이급혈청전단백(PA)적변화.결과 관찰조지속병정(55.2±8.3)d,명현단우대조조적(87.7±10.5)d,량조비교차이유통계학의의(t=-18.872,P＜0.05)；관찰조치유솔위95.2％,대조조위6.2％,량조비교차이유통계학의의(x2=77.235,P＜0.05)；관찰조병사1례(1.6％),후유증6례(8.6％),명현저우대조조(5,13례),량조비교차이유통계학의의(x2=5.062,5.985；P＜0.05).관찰조발생상소화도출혈0례,전해질문란5례,간신공능손해2례,신경공능손해10례,여대조조비교(분별위9,16,10,23례),차이균유통계학의의(x2치분별위10.401,7.910,6.541,8.319;P ＜0.05).관찰조치료후TP、ALB、PA함량명현교치료전제고,여대조조비교[(68.2±2.3)/(61.5±2.1)g/L,(36.8 ±2.1)/(31.7 ±2.0)g/L,(251.8±30.01)/(173.1±27.6)mg/L],차이구유통계학의의(t치분별위14.149,12.842,10.792;P ＜0.05).결론 호리간예연합장내영양과유효축단환자병정,제고치유솔,강저병사솔급병발증,병유효제고TP、ALB급PA적함량.
Objective To explore the effect of enteral nutrition with nursing intervention on the prognosis of the patients with severe intestinal dysfunction in Neurology.Methods One hundred and twenty patients were chosen and randomly divided into the control group (n =58) and the observation group (n =62)from July 2011 to June 2012.The control group received enteral nutrition and routine care.The observation group received enteral nutrition and complications of care on the basis of the routine care.The course of disease,the cure rate,mortality,sequelae and complications were observed in patients.The serum total protein (TP),serum albumin (ALB) and serum precursor protein (PA) were detected in the two groups.Results The course of disease was (55.2 ± 8.3) d in the observation group,shorter than (87.7 ± 10.5) d in the control group,the difference was statistically significant (t =-18.872,P ＜ 0.05).The cure rate was 95.2％ in the observation group,higher than 36.2％ in the control group,the difference was statistically significant (x2 =77.235,P ＜0.05).The mortality (one case,1.6％) and sequelae (six cases,8.6％) of the observation group were lower than those of the control group (five and thirteen cases,respectively),the difference between the control and observation group was statistically significant (x2 =5.062,5.985,respectively; P ＜ 0.05).The major complications of upper gastrointestinal bleeding,electrolyte imbalance,liver and kidney dysfunction and neurological impairment was respectively 0,5,2,10 cases in the observation group,and 9,16,10,23 cases in the control group,the difference was statistically significant (x2 =10.401,7.910,6.541,8.319,respectively;P ＜0.05).The TP,ALB,PA in the observation group were significantly increased after the treatment,and higher than those of the control group [(68.2 ± 2.3) / (61.5 ± 2.1) g/L,(36.8 ± 2.1) / (31.7 ± 2.0) g/L,(251.8 ± 30.01)/(173.1 ± 27.6)mg/L],the difference was statistically significant (t =14.149,12.842,10.792; P ＜ 0.05).Conclusions The enteral nutrition with nursing intervention can effectively shorten the patient's course of disease,improve the cure rate,reduce mortality and complications and improve the TP,ALB and PA in serum.