摘要
目的构建基于循证的预防颅脑损伤肠内营养患者并发腹泻的集束化干预方案,并验证其效果,以期为临床降低颅脑损伤肠内营养患者腹泻发生率提供最佳证据,提高护理质量。方法采用非同期对照试验方法,便利抽样法选取六安市中医院神经外科收治的行肠内营养治疗的颅脑损伤患者作为研究对象,将2021年1月至2022年3月采用常规肠内营养护理的52例作为对照组,将2022年4月至2024年2月采用基于循证的集束化预防干预的51例作为观察组。干预14 d后,比较2组患者腹泻情况[腹泻发生率、排便性状(水样便、稀软便)、排便次数、腹泻发生时间及腹泻持续时间]、其他并发症情况、营养状态(血清总蛋白、血清白蛋白及血红蛋白)及护理满意度。结果2组患者均完成研究。对照组男33例,女19例,年龄(53.96±17.44)岁,观察组男37例,女14例,年龄(60.05±18.61)岁。观察组腹泻及水样便发生率分别为11.76%(6/51)和7.84%(4/51),低于对照组的28.85%(15/52)及23.08%(12/52),差异均有统计学意义(χ^(2)=4.63、4.55,均P<0.05)。观察组排便次数为(6.71±1.64)次,少于对照组的(9.34±2.10)次,差异有统计学意义(t=7.08,P<0.05)。观察组腹泻发生时间为(1.97±0.54)d,晚于对照组的(1.59±0.42)d,差异有统计学意义(t=3.99,P<0.05)。观察组腹泻持续时间为(3.11±0.86)d,短于对照组的(5.12±1.74)d,差异有统计学意义(t=7.41,P<0.05)。观察组其他并发症总发生率为9.80%(5/51),低于对照组的25.00%(13/52),差异有统计学意义(χ^(2)=4.12,P<0.05)。干预14 d后,观察组患者血清总蛋白、血清白蛋白及血红蛋白水平分别为(60.58±6.37)、(41.29±8.24)、(120.81±11.72)g/L,高于对照组的(57.86±6.15)、(37.56±7.64)、(111.26±11.25)g/L,差异均有统计学意义(t=2.21、2.38、4.22,均P<0.05)。观察组患者护理总满意度为96.08%(49/51),高于对照组的80.77%(42/52),差异有统计学意义(χ^(2)=5.86,P<0.05)。结论对颅脑损伤肠内营养患者实施基于循证的集束化预防干预可降低患者腹泻发生率,利于患者营养状态恢复,提高护理满意度。
Objective To construct an evidence-based cluster intervention program for the prevention of enteral nutrition complicated with diarrhea in patients with craniocerebral injury,and to verify its effect,in order to provide the best evidence for reducing the incidence of enteral nutrition complicated with diarrhea in patients with craniocerebral injury and improve the quality of nursing.MethodsBy the method of non-synchronous controlled trials,the patients with craniocerebral injury treated by enteral nutrition in the Department of Neurosurgery,Lu'an Hospital of Traditional Chinese Medicine were selected as the research objects by convenient sampling method.Fify-two cases of routine intervention from January 2021 to March 2022 were divided into control group,and 51 cases of evidence-based cluster prevention intervention from April 2022 to February 2024 were divided into observation group.After 14 days of intervention,diarrhea[incidence of diarrhea and defecation traits(watery stool,loose stool),frequency of defecation,time of diarrhea and duration of diarrhea],other complications,nutritional status(serum total protein,serum albumin and hemoglobin),and nursing satisfactory degree were compared between the two groups.ResultsBoth groups of patients completed the study.There were 33 males and 19 females in the control group,aged(53.96±17.44)years old,and 37 males and 14 females in the observation group,aged(60.05±18.61)years old.The incidence of diarrhea and watery stools in the observation group was 11.76%(6/51)and 7.84%(4/51),respectively,which was lower than the 28.85%(15/52)and 23.08%(12/52)in the control group,and the differences were statistically significant(χ^(2)=4.63,4.55,both P<0.05).The frequency of defecation in the observation group was(6.71±1.64)times,which was lower than that in the control group(9.34±2.10)times,and the difference was statistically significant(t=7.08,P<0.05).The occurrence time of diarrhea in the observation group was(1.97±0.54)d,which was later than that in the control group(1.59±0.42)d,and the difference was statistically significant(t=3.99,P<0.05).The duration of diarrhea in the observation group was(3.11±0.86)d,which was shorter than that in the control group(5.12±1.74)d,and the difference was statistically significant(t=7.41,P<0.05).The incidence of other complications in the observation group was 9.80%(5/51),which was lower than the 25.00%(13/52)in the control group,and the difference was statistically significant(χ^(2)=4.12,P<0.05).After 14 days of intervention,the serum total protein,serum albumin,and hemoglobin levels in the observation group were(60.58±6.37),(41.29±8.24),(120.81±11.72)g/L,respectively,which were higher than those in the control group(57.86±6.15),(37.56±7.64),(111.26±11.25)g/L,and the differences were statistically significant(t=2.21,2.38,4.22,all P<0.05).The patients′overall satisfaction with nursing care in the observation group was 96.08%(49/51),which was higher than the control group′s 80.77%(42/52),and the difference was statistically significant(χ^(2)=5.86,P<0.05).ConclusionsThe implementation of evidence-based cluster prevention intervention for enteral nutrition patients with craniocerebral injury can reduce the incidence of diarrhea in patients,which is conducive to the recovery of nutritional status,improve nursing satisfaction.
作者
李大苇
李道昌
沈丽
赵丽
Li Dawei;Li Daochang;Shen Li;Zhao Li(Department of Neurosurgery,Lu'an Hospital of Traditional Chinese Medicine,Lu'an 237000,China)
出处
《中国实用护理杂志》
2025年第7期481-486,共6页
Chinese Journal of Practical Nursing
基金
安徽省红十字会中医药传承创新发展研究项目(2021ZYZD04)。
关键词
颅脑损伤
腹泻
肠内营养
循证
集束化
Craniocerebral trauma
Diarrhea
Enteral nutrition
Evidence-based
Bundling
