医护一体化护理模式在重症急性胰腺炎患者保守治疗中的应用及效果.docVIP

医护一体化护理模式在重症急性胰腺炎患者治疗中的应用重症急性胰腺炎治疗患者he effect of doctor-nurse integration mode on conservative treatment in patients with severe acute pancreatitis Abstract Objective To evaluate the effect of doctor-nurse integration mode on conservative treatment in patients with severe acute pancreatitis. Methods 96 severe acute pancreatitis patients with conservative treatment were randomly divided into observation group（n=48）and control group（n=48）. The doctor-nurse integration mode was used in observation group and routine nursing was used in control group. The self-rating depression scale (SDS) score, self-rating anxiety scale (SAS) score, pittsburgh sleep rating scale score, complications rate, hospital stays, fasting time and mortality were compared between the two groups. Results The SDS score, SAS score, pittsburgh sleep rating scale score, complications rate, hospital stays, fasting time and mortality were significantly lower than the control group, the difference showed statistically significant (P0.05). Conclusion The doctor-nurse integration mode can improve the nursing quality of severe acute pancreatitis conservative treatment，improve the prognosis of patients, worthy of clinical popularization and application. Keyword: Severe acute pancreatitis; Conservative treatment; Doctor-nurse integration 重症急性胰腺炎（sever acute pancreatitis，SAP）属于临床常见急腹症，具有病情进展凶险、并发症多、预后差等特点，其病死率高达20%左右[1]。手术治疗SAP可引起机体内环境紊乱、胰腺坏死，并增加术后感染的易感性，内科保守治疗可有效改善SAP预后，是内外科医生的共识[2]。有效的护理干预对提高保守治疗效果及改善患者预后等方面均具有积极作用[3]。在传统护理管理模式中，护理人员职责模糊不清仅简单、被动地成为医嘱的执行者，导致护理干预效果欠佳。为规范重症急性胰腺炎保守治疗期间护理干预流程，深化“以患者为中心”的服务理念，我科在创建优质护理服务示范工程中，建立以医护一体化管理模式为主体的护理干预，并取得满意效果，现报道如下。 1 资料与方法 1.1 一般资料 选取2013年9月至2014年9月我院收治的重症胰腺炎患者共96例为研究对象，所有入组患者均符合中华医学会外科学分会胰腺外科学组制定的重症胰腺炎诊断标准[4]。纳入标准：（1）知情同意并签署知情同意书者；（2）发病72h内入院治疗者；（3）行内科保守治疗者。排除标准：（1）精神病患者、哺乳期及妊娠期妇女；（2）认知功能障碍者。按随机数字表法将入组患者分为对照组和观察组。对照组48例，男性26例，女性22例；年龄23～71岁，平均年龄（43.8±9.7）岁；病因：酒精性胰腺炎24例，胆源性胰腺炎16例，暴饮暴食性胰腺炎8例。观察组48例，男性25例，女性23例；年龄20～69岁，平均年龄（44.5±9.1）岁；病因：酒精性胰腺炎22例，胆源性胰腺炎17例，暴饮暴食性胰腺炎9例