早期集束化护理对小儿脓毒症患者肠功能的预防效果观察论文

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1、早期集束化护理对小儿脓毒症患者肠功能的预防效果观察论文［摘要］目的探讨早期集束化护理对小儿脓毒症患者肠功能的预防效果。方法将80例小儿脓毒症患者按照护理方式随机分为对照组与观察组，分别采用常规护理与早期集束化护理干预。比较两组患儿护理干预前后急性生理学及慢性健康状况评分系统、肠功能障碍评分、D-乳酸水平变化情况。结果①两组护理后APACHEII评分均显著小于护理前,且观察组护理后APACHEII评分小于对照组；对照组护理前后肠功能障碍评分差异无统计学意义，但观察组护理后肠功能障碍评分显著小于护理前及对照组护理后；②两组护理后血浆D-乳酸水平均显著

2、小于护理前，且观察组护理后血浆D-乳酸水平显著小于对照组。结论早期集束化护理对小儿脓毒症患者肠功能的预防效果显著，应在临床上进行推广应用。［中图分类号］R472.［文献标识码］B［文章编号］1673-970112-0144-03PreventionofearlyclusternursingofpediatrieobservationbowelfunctioninpatientswithsepsisZHANGXuemeiDepartmentofPediatrics,MaternalandChildHea1thHospitalofZiboCityin

3、ShandongProvince,Zibo55029,China[Abstract]ObjectiveToinvestigatetheeffectofearlyclusterofpreventivecareforchildrenwithbowelfunctioninpatientswithsepsis・MethodsAtotalofOcasesofpediatriecareinaccordancewiththemannerinpatientswithsepsiswererandomlydividedintocontrolgroupwiththeo

4、bservationgroup,respectively,usingconventionalclusternursingcareandearlyintervention.Twogroupsofchildrenbeforeandafternursinginterventioninacutephysiologyandchronichea1thevaluation，intestinaldysfunctionscore,D~lactatelevelchanges・ResultsaftertwotreatmentsAPACHEIIscoresweresig

5、nificantlylowerthanbeforetreatment,andtheAPACHEIIscoreinobservationgroupwaslessthanthatinthecontrolgroupaftertreatment；thecontrolgroupbeforeandaftertreatmentofintestinaldysfunctionscorehadnosignificantdifference,buttheobservationgroupcareandboweldysfunctionscoresweresignifica

6、ntlylowerthanpre-treatmentandpost-treatmentcontrolgroup；thetwogroupsaftertreatmentplasmaD-lactatelevelsweresignificantlylowerthancarebefore,andtheobservationgroup，sD~plasmalactatelevelsweresignificantlylowerthanthecontrolgroupaftertreatment・ConclusionEarlyclusternursingpreven

7、tiveeffectonbowelfunctioninpatientswithsepsisinchildrensignificantlyandshouldbepromotedinclinicalapplications.［Keywords］Pediatricsepsis；Clusternursing；Preventiveeffect；Bowelfunction脓毒症是一种由感染因素而造成的全身炎性反应综合征。全世界每年该病的临床发病率约为180万，严重脓毒症病死率高达30%左右［1］。临床研究证实，脓毒症时发生肠功能障碍造成肠道菌群失调与细菌移位

8、，是造成多脏器功能衰竭的始动因素，肠道作为体内最大的一种免疫器官、储菌库以及内毒素库，参与了MODS的病理生理学过程［2,3］。由此可以