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目的探讨持续血液净化(CBP)配合护理干预治疗重症急性胰腺炎(SAP)的临床疗效。方法回顾性分析温州医科大学附属医院自2013年6月—2014年6月共收治的40例SAP患者的临床资料,对患者给予胰腺炎常规治疗配合血液净化治疗及护理干预,分别记录治疗前后患者的体温、血压、呼吸等生命体征,并进行APACHEⅡ评分,对比观察治疗前后患者血清淀粉酶、肝肾功能、动脉血气分析等指标,判断病情变化。结果 40例重症急性胰腺炎患者35例治愈出院,5例死亡,存活率为87.5%,持续血液净化治疗时间为(73.8±6.2)h,在持续血液净化治疗和护理后,所有治愈患者病情均得到缓解,各项生命体征及APACHEⅡ评分在治疗前及治疗并护理后差异具有统计学意义(P<0.05);各项生化指标在CBP治疗及治疗并护理后均发生显著改变,其中血清总胆红素(TB)、淀粉酶(AMS)等指标较治疗前下降,比较差异具有统计学意义(P<0.05)。酸碱失衡得到纠正,电解质紊乱得到改善。结论采用持续血液净化配合护理干预治疗重症急性胰腺炎患者效果明显,配合针对性护理干预临床效果满意,建议临床推广。护理人员的配合是治疗过程中不可或缺的,不仅体现在以上这些监测指标的实施及辨别,护理干预更参与到整个治疗过程的始末。
Objective To investigate the clinical efficacy of continuous blood purification (CBP) combined with nursing intervention in the treatment of severe acute pancreatitis (SAP). Methods The clinical data of 40 SAP patients admitted to the Affiliated Hospital of Wenzhou Medical University from June 2013 to June 2014 were retrospectively analyzed. The patients were treated with routine pancreatitis treatment combined with blood purification treatment and nursing intervention. The patients before and after treatment The body temperature, blood pressure, respiration and other vital signs, and APACHE Ⅱ score, compared the observation of patients before and after treatment of serum amylase, liver and kidney function, arterial blood gas analysis and other indicators to determine the condition changes. Results 35 cases of 40 patients with severe acute pancreatitis were cured and discharged, 5 died, the survival rate was 87.5%, and the continuous blood purification treatment time was (73.8 ± 6.2) h. After the continuous blood purification treatment and nursing, all cured patients were (P <0.05). All the biochemical indexes changed significantly after treatment and treatment of CBP and nursing, in which the serum total gallbladder The indexes of TB, amylase (AMS) decreased compared with those before treatment, with significant difference (P <0.05). Acid-base imbalances were corrected, and electrolyte imbalances improved. Conclusion Continuous blood purification combined with nursing intervention in patients with severe acute pancreatitis has obvious effect, with targeted nursing intervention clinical effect is satisfactory, it is recommended clinical promotion. Nursing staff cooperation is indispensable in the treatment process, not only reflected in the above indicators of the implementation of monitoring and identification, nursing interventions are more involved throughout the entire course of treatment.