摘要
目的 分析目标导向性护理结合平均动脉压(MAP)及心率(HR)评估在脓毒症患者中的应用价值。方法 选取淄博市淄川区医院2022年6月至2024年6月收治的104例脓毒症患者,使用简单随机抽样法将其分别纳入观察组和对照组,各52例。2组均接受综合治疗和常规护理,观察组加用结合MAP和HR评估的目标导向性护理,对比2组的护理效果。结果 观察组在护理12 h、24 h后的急性生理和慢性健康状况Ⅱ和序贯器官衰竭评分均较同一时间点对照组的评分更低(P均<0.05),且2组均低于护理前(P均<0.05)。观察组在护理12 h后的MAP、中心静脉压(CVP)、中心静脉血氧饱和度(ScvO_(2))均较对照组更高,HR较对照组更慢,心排血量(CO)、射血分数(EF)均较对照组更大,二尖瓣E峰与二尖瓣环e'峰速度比值较对照组更小(P均<0.05),且2组均优于护理前(P均<0.05)。观察组的6 h液体复苏达标率较对照组更高,6 h液体复苏用量少于对照组,28 d病死率较对照组更低(P均<0.05)。结论 结合MAP及HR开展目标导向性护理能够改善脓毒症患者的病情、血流动力学和心功能,且能够实现更高的早期液体复苏达标率,减少液体复苏用量,降低病死率。
Objective To analyze the application value of goal-directed nursing combined with mean arterial pressure(MAP)and heart rate(HR)assessment in patients with sepsis.Methods A total of 104 patients with sepsis admitted to Zichuan District Hospital in Zibo from June 2022 to June 2024 were selected and randomly divided into an observation group and a control group using a simple random sampling method,with 52 patients in each group.Both groups received comprehensive treatment and routine nursing.The observation group received an additional goal-directed nursing combined with MAP and HR assessment.The nursing effects of the two groups were compared.Results After 12 h and 24 h of nursing,the Acute Physiology and Chronic Health EvaluationⅡscores and the Sequential Organ Failure Assessment scores in the observation group were lower than those in the control group at the same time point(P<0.05),and both groups had lower scores compared to before nursing(P<0.05).The MAP,central venous pressure(CVP),and central venous blood oxygen saturation(ScvO_(2))of the observation group were higher than those of the control group after 12 h of nursing.The HR was slower than that of the control group.The cardiac output(CO)and ejection fraction(EF)were higher than those of the control group,and the ratio of mitral E wave velocity to mitral annular ewave velocity was smaller than that of the control group(P<0.05).Both groups were better compared with before nursing(P<0.05).The observation group had a higher compliance rate with 6-hour fluid resuscitation,less volume of fluid resuscitation within 6 hours,and a lower 28-day mortality rate compared with the control group(P<0.05).Conclusion The implementation of goal-directed nursing combined with MAP and HR can improve the condition,hemodynamics,and cardiac function of sepsis patients,and can achieve higher early fluid resuscitation compliance rates,reduce fluid resuscitation volume,and reduce mortality rates.
作者
刘俊
车媛媛
谭媛媛
LIU Jun;CHE Yuanyuan;TAN Yuanyuan(Zichuan District Hospital,Zibo,Shandong,255100,China)
出处
《中西医结合护理(中英文)》
2025年第5期101-104,共4页
Journal of Clinical Nursing in Practice
