4R危机管理理论在脓毒症患者胃肠功能障碍预防管理中的应用

目的　探讨4R危机管理理论在脓毒症患者胃肠功能障碍预防管理中的应用效果。方法　选择2020年12月至2021年12月广东省第二中医院收治的82例脓毒症患者为研究对象进行前瞻性研究，运用随机数字表法将其分为对照组和观察组，各41例。对照组男23例、女18例，年龄（76.17±9.27）岁，实施脓毒症常规护理干预；观察组男22例、女19例，年龄（77.22±9.03）岁，在对照组基础上实施基于4R危机管理理论的胃肠功能障碍预防管理。比较两组患者急性生理与慢性健康评分系统Ⅱ（APACHEⅡ）评分、胃肠功能损伤评分、胃肠功能障碍发生率以及护理满意度。计量资料行独立样本t检验，计数资料行χ²检验。结果　干预后，观察组APACHEⅡ评分、胃肠功能损伤评分［（19.41±3.15）分、（24.85±4.49）分］均低于对照组［（23.27±3.41）分、（29.07±5.12）分］，差异均有统计学意义（t=5.315、3.969，均P<0.001）。干预后，观察组患者胃肠功能障碍发生率为7.32%（3/41），明显低于对照组24.39%（10/41），差异有统计学意义（χ²=4.479，P=0.034）。干预后，观察组患者护理总满意度为97.6%（40/41），高于对照组85.4%（35/41），差异有统计学意义（χ²=3.905，P=0.048）。结论　运用4R危机管理理论可改善脓毒症患者病情和胃肠功能，降低胃肠功能障碍发生率，提高护理满意度。

Application of 4R crisis management theory in the prevention management of gastrointestinal dysfunction in patients with sepsis

Objective　To explore the application effect of 4R crisis management theory in the prevention management of gastrointestinal dysfunction in patients with sepsis. Methods　A total of 82 patients with sepsis treated in Guangdong Second Traditional Chinese Medicine Hospital from December 2020 to December 2021 were selected as the research objects for a prospective study, and they were divided into a control group 23 males and 18 females, aged (76.17±9.27) years]and an observation group 22 males and 19 females, aged (77.22±9.03) years] with 41 cases in each group by the random number table method. The control group received routine nursing intervention for sepsis, and the observation group received preventive management of gastrointestinal dysfunction based on 4R crisis management theory. The score of Acute Physiology and Chronic Health Evaluation Scoring System (APACHEⅡ), gastrointestinal function injury score, incidence of gastrointestinal dysfunction, and nursing satisfaction were compared between the two groups. Independent sample t test was used for the measurement data, and χ² test for the count data. Results　After intervention, the APACHEⅡ score and gastrointestinal function injury score of the observation group (19.41±3.15) and (24.85±4.49)] were lower than those of the control group (23.27±3.41) and (29.07±5.12)], with statistically significant differences (t=5.315 and 3.969; both P<0.001). After intervention, the incidence of gastrointestinal dysfunction in the observation group was 7.32% (3/41), which was significantly lower than 24.39% (10/41) in the control group, with a statistically significant difference (χ²=4.479, P=0.034). After intervention, the total nursing satisfaction rate in the observation group was 97.6% (40/41), which was higher than 85.4% (35/41) in the control group, with a statistically significant difference (χ²=3.905, P=0.048). Conclusion　Applying 4R crisis management theory can improve the condition and gastrointestinal function in patients with sepsis, reduce the incidence of gastrointestinal dysfunction, and improve the nursing satisfaction.