肝硬化急性上消化道出血的Rockall危险性积分评价及护理对策

目的]研究以Rockall危险性积分评估肝硬化急性上消化道出血(AUGIB)患者的危险级别,并据此给予专项护理对策的临床效果.方法]本院于2014年1月起对肝硬化急性上消化道出血患者进行Rockall危险性积分评估,并根据评估结果对患者进行分级专项护理,以2014年1~12月间护理的57例患者作为观察组,回顾本院2013年1~12月间护理的51例患者临床资料作为对照组,对比两组患者的临床疗效、止血时间、住院时间、再出血率、并发症发生率以及病死率.结果]观察组临床总有效率为91.23%,明显优于对照组76.47%的临床总有效率;其再出血率(8.77%)和临床病死率(1.75%)及并发症发生率(5.26%)也明显低于对照组(27.45%和9.80%及25.49%),其差异均有统计学意义(均P<0.05).观察组止血时间和住院时间分别为(2.09±0.59)d和(12.06±2.45)d,分别较对照组的(3.26±0.92)d和(16.76±3.02)d均显著减少(P<0.05).观察组患者对护理工作的总满意率为92.98%,优于对照组的76.47%,其差异也具有显著性(P<0.01).结论]对肝硬化AUGIB患者进行Rockall危险性积分评估,并据此给予分级专项护理,可提高护理工作的针对性,从而有效的降低并发症的发生率,缩短患者康复时间,提高临床疗效及患者满意度,可于本病的临床护理工作中推广应用.

Application of Rockall Risk Score in Evaluation of Acute Upper Gastrointestinal Bleeding in Cirrhosis and Nursing Countermeasures

Objective]To evaluate the risk of patients with acute upper gastrointestinal bleeding ( AUGIB) by cirrhosis with the Rockall risk score and to apply the clinical effects of corresponding nursing measures. Methods]In the year 2014, 57 patients with acute upper gastrointestinal bleeding ( observation group) by cirrhosis were assessed by Rockall risk score. According to the evaluation results, patients were graded and applied for special care. A total of 51 AUGIB patients were recruited from January 2013 to December 2013 for routine nursing care as the control group. The clinical efficacy, hemostasis time, hospital stay, re-bleeding rate, complication incidence and mortality rate of the above two groups were compared.Results]The overall clinical effective rate was 91.23% in the observation group and 76.47% in the control group. The clinical efficacy of the observation group was better than that of the control group ( P<0.05). The re-bleeding rate and the clinical mortality in the observation group were 8.77% and 1.75%, respectively. The re-bleeding rate and the clinical mortality rate in the observation group were 27.45% and 9.80%,re-spectively.The complication incidence in the observation group was 5.26%, and the complication rate in the control group was 25.49%;the complication rate in the observation group was significantly lower than that in the control group ( P <0.01) . In the observation group, the time of hemostasis was 2.09 ± 0.59 days and the hospital stay was 12.06 ± 2.45 days,while in the control group, the hemostasis time was 3.26 ± 0.92 days and the hospital stay was 16.76 ± 3. 02 days. The hemostasis time and hospitalization time of the observation group were significantly less than those of the control group ( P<0.05) . The total satisfaction rate was 92.98% in the observation group and 76.47% in the control group. The satisfaction degree of the nursing group in the observation group was significantly more than that in the control group ( P<0.01) . Conclusion]The assessment of Rockall risk score in patients with acute upper gastrointes-tinal hemorrhage of liver cirrhosis can guide clinical corresponding special nursing care and thus effectively reduce the incidence of complications, shorten the rehabilitation time and improve Clinical efficacy and patient satisfaction.