超声引导的肠道清洁在重症急性胰腺炎患者中的应用研究

doi:10.3761/j.issn.0254-1769.2024.13.006

摘要/Abstract

摘要：

目的探讨超声引导的肠道清洁在重症急性胰腺炎患者中的应用效果。方法采用方便抽样法，选取2023年3月—9月在山东省某三级甲等综合医院ICU接受治疗的51例重症急性胰腺炎患者为研究对象，采用随机数字表法，分为试验组（n=26）和对照组（n=25）。试验组实施超声引导的肠道清洁，对照组实施常规的肠道清洁。比较两组干预前、第3天和第5天急性胃肠损伤超声评分及腹内压、干预前后急性胃肠损伤Ⅲ级发生率的差异。结果两组急性胃肠损伤超声检查评分比较时间与组间存在交互效应（F_交互=7.478，P_交互<0.001）；简单效应分析显示，干预第3天和第5天，试验组急性胃肠损伤超声检查评分均低于对照组，差异有统计学意义（P<0.05）。试验组急性胃肠损伤Ⅲ级发生率（23%）低于对照组（60%），差异具有统计学意义（P<0.05）。两组腹内压比较时间与组间存在交互效应（F_交互=47.128，P_交互<0.001）；简单效应分析显示，干预第3天、第5天，试验组腹内压均低于对照组，差异有统计学意义（P<0.05）。结论超声引导的肠道清洁有助于改善重症急性胰腺炎患者的急性胃肠损伤，降低腹内高压。

关键词: 重症急性胰腺炎, 超声, 肠道清洁, 重症监护病房, 护理

Abstract:

Objective To investigate the application effect of a bedside ultrasound-guided intestinal cleaning program in patients with severe acute pancreatitis. Methods A total of 51 patients with severe acute pancreatitis admitted to the ICU of a tertiary A hospital in Shandong from March to September 2023 were selected by convenience sampling method，and they were divided into an experimental group and a control group according to random number table method. The experimental group was given the bedside ultrasound-guided intestinal cleaning program，and the control group was given the routine intestinal cleaning program. Acute gastrointestinal injury ultrasonography score，the incidence of grade Ⅲ acute gastrointestinal injury and intra-abdominal pressure were compared between the 2 groups before intervention，on the 3rd and 5th day. Results There was an interaction effect between time and group in the comparison of acute gastrointestinal injury ultrasonography scores in the 2 groups（F=7.478，P<0.001）；simple effect analysis showed that acute gastrointestinal injury ultrasonography scores in the experimental group were lower than those in control group on the 3rd and 5th day，with statistically significant differences（P<0.05）. The incidence of grade Ⅲ acute gastrointestinal injury in the experimental group （23%） was lower than that in the control group（60%），with statistically significant differences（P<0.05）. The intra-abdominal pressure had an interaction effect between the 2 groups（F=47.128，P<0.001）；simple effect analysis showed that the intra-abdominal pressure in the experimental group was lower than that in the control group on the 3rd and 5th day，with statistically significant differences（P<0.05）. Conclusion The bedside ultrasound-guided intestinal cleaning program can improve acute gastrointestinal injury and reduce intra-abdominal hypertension in patients with severe acute pancreatitis.

Key words: Severe Acute Pancreatitis, Ultrasound, Intestinal Cleaning, Intensive Care Unit, Nursing Care

金晓蕾, 黄瑞, 回雪英, 郭祥勇, 张跃忠, 侯晓红, 倪庆强, 方巍, 王玉萍. 超声引导的肠道清洁在重症急性胰腺炎患者中的应用研究[J]. 中华护理杂志, 2024, 59(13): 1575-1580.

JIN Xiaolei, HUANG Rui, HUI Xueying, GUO Xiangyong, ZHANG Yuezhong, HOU Xiaohong, NI Qingqiang, FANG Wei, WANG Yuping. Application of a bedside ultrasound-guided intestinal cleaning program in patients with severe acute pancreatitis[J]. Chinese Journal of Nursing, 2024, 59(13): 1575-1580.

图/表 5

表1 急性胃肠损伤超声检查评分

Table 1 Acute gastrointestinal injury ultrasonography score

表2 两组一般资料的比较

Table 2 Comparison of baseline information between the 2 groups

表3 两组急性胃肠损伤超声评分的比较（分，$\bar{x} \pm s$）

Table 3 Comparison of acute gastrointestinal injury ultrasonography score between the 2 groups（score，$\bar{x} \pm s$）

表4 两组急性胃肠损伤Ⅲ级发生率的比较[例（百分率，%）]

Table 4 Comparison of acute gastrointestinal Ⅲ incidence rates between 2 groups[case（percentage，%）]

表5 两组腹内压的比较（mmHg，$\bar{x} \pm s$）

Table 5 Comparison of intra-abdominal pressure between 2 groups（mmHg，$\bar{x} \pm s$）

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