急性非静脉曲张性上消化道出血患者再出血危险评估和临床分级护理干预效果

摘要

Objective To evaluate the re-bleeding risk severity and the clinical efficacy of clinical grading nursing intervention in patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB) using Rockall risk scoring.Methods A total of 56 patients from January to December 2014 were selected as control group while another 51 cases from January to December 2015 were as experimental group.Control group was added with routine nursing while experimental group with clinical grading nursing intervention based on Rockall risk scoring on the basis of treatment for gastrointestinal bleeding.The occurrence rate of re-bleeding during hospitalization was observed inboth groups,the improvement of anxiety and depression as well as patients'cognition on disease and behaviors following doctors'advice were compared between two groups.Results The total occurrence rate of re-bleeding was 7.8％ in experimental group,evidently lower than the 25.0％ in control group (P ＜0.05).After intervention,self-rating depression scale (SDS) and self-rating anxiety scale (SAS) decreased in both groups (P ＜0.05 or P ＜0.01),which decreased more significantly in experimental group than that in control group (P ＜0.01).Experimental group was markedly higher in the number of patients who grasped the knowledge and cognitive behaviors on disease (P ＜ 0.05 or P ＜ 0.01) as well as the compliance of behaviors following doctors'advice than control group (P ＜ 0.05).Conclusion Clinical grading nursing intervention based on Rockall risk scoring can effectively reduce the re-bleeding risk of patients with ANVUGIB,relieve their anxiety and depression,and improve their cognition on disease and behaviors following doctors'advice.%目的 运用Rockall危险性积分评估急性非静脉曲张性上消化道出血(ANVUGIB)患者再出血危险程度,并评估临床分级护理干预效果.方法 将2014年1-12月入院的56例患者设为对照组,将2015年1-12月入院的51例患者设为实验组.在消化道出血治疗基础上,对照组给予常规护理,实验组实施基于Rockall危险性积分的临床分级护理干预.观察2组住院期间再出血发生情况,对比2组焦虑、抑郁情绪改善情况,以及患者疾病认知和遵医嘱行为.结果 实验组再出血总发生率7.8％,显著低于对照组的25.0％(P＜0.05);干预后,2组SDS和SAS评分均显著下降(P＜0.05或P＜0.01),且实验组显著低于对照组(P＜0.01);实验组疾病知识和认知行为掌握人数比例显著高于对照组(P＜0.05或P＜0.01),遵医嘱行为依从率显著高于对照组(P＜0.05).结论 基于Rockall危险性评分的临床分级护理干预能有效降低ANVUGIB患者再出血风险,缓解焦虑、抑郁情绪,提高患者疾病认知和遵医嘱行为.