重症烧伤患者急救期输液及营养的路径护理分析(1)
[摘要]目的 探讨路径护理在重症烧伤患者急救期输液及营养中的应用价值。方法 选取我院烧伤科2013年8月～2015年7月收治的重度烧伤患者68例，将其分为常规护理组和路径护理组，各34例，常规护理组采取常规护理模式，路径护理组采用路径护理模式。记录护理过程中静脉通道重复建立、静脉炎、休克及不良反应发生情况，检测护理前和护理后5 d、10 d血清白蛋白(ALB)、血红蛋白(Hb)水平，并评估护理后10 d两组患者营养状况。结果 路径护理组静脉通道重复建立比例、静脉炎和休克发生率及感染、腹泻、呕吐发生率均明显低于常规护理组(P<0.05)；与护理前比较，护理后两组ALB、Hb水平均显著升高(P<0.01)，且路径护理组明显高于常规护理组(P<0.05)；护理10 d后，路径护理组氮平衡值为(0.88±0.10)明显高于常规护理组的(0.56±0.08)(t=14.57，P=0.000)。结论 重症烧伤患者急救期输液及营养方面行路径护理可以显著提高患者营养状况，降低不良反应发生率，改善预后。
[关键词]路径护理；重症烧伤；急救期
[中图分类号] R248.2 [文献标识码] A [文章编号] 1674-4721(2016)06(a)-0179-04
[Abstract]Objective To explore the effectiveness of application of pathway nursing in infusion and nutritionfor emergency treatment of patients with severe burn.Methods A total of 68 cases of severe burn patients who had been treated in department of burn of the hospital from August 2013 to July2015were involved in this study and evenly divided into Routine Nursing Group and Pathway Nursing Group，34 cases in each group.Routine nursing group was treated with the routine nursing mode；while，Pathway nursing group accepted treatment of the pathway nursing model.The repeated establishmentof venous channel，phlebitis，shock，incidence of adverse reaction in the process of nursing，pre-and post-nursing detection(5 d and 10 d after nursing) of the serum albumin (ALB) and hemoglobin (HB) levels were recorded；and the nutritional status of both groups were evaluated 10 daysafter nursing.Results The repeated establishment rate of venous channel，phlebitis，the incidence of shock，infection，diarrheaand vomiting of pathwaynursing groupwere significantly lower than those of routine nursing group (P<0.05)；compared with the preoperative care，the ALB and Hb levels of both groups significantly increased (P<0.01) and the ALB and Hb levels of pathway nursing group were significantly higher than those of routine nursing group (P<0.05)；10 days after nursing，the nitrogen balance value(0.88±0.10) of pathway nursing group was significantly higher than that of routine nursing group (0.56±0.08) (t=14.57， P=0.000).Conclusion Application of pathway nursing in infusion and nutrition for emergency treatment of patients with severe burn can significantly improve patients′ nutritional status，reduce the incidence of adverse reactions，and improve the prognosis of patients with severe burn.
[Key words]Pathway nursing；Severe burn；Emergency treatment
重症烧伤患者由于大面积的烧伤增加了机体代谢与能量消耗，加之机体抵抗力急剧下降，极易并发感染和多器官功能损伤，若处理不及时或治疗不当，会造成较高的死亡率[1]。重症烧伤治疗期间需要及时补充大量的电解质和能量，给予足够的营养支持，以免造成电解质紊乱，危及患者生命。临床路径可以根据患者不同临床情况制定个体化、标准化和流程化的诊疗和护理方案，而被广泛应用于临床[2-3]，我院采用路径护理模式，在重症烧伤患者急救期的输液及营养护理过程中取得较好的临床效果，现报道如下。 (谢茜宇)
[关键词]路径护理；重症烧伤；急救期
[中图分类号] R248.2 [文献标识码] A [文章编号] 1674-4721(2016)06(a)-0179-04
[Abstract]Objective To explore the effectiveness of application of pathway nursing in infusion and nutritionfor emergency treatment of patients with severe burn.Methods A total of 68 cases of severe burn patients who had been treated in department of burn of the hospital from August 2013 to July2015were involved in this study and evenly divided into Routine Nursing Group and Pathway Nursing Group，34 cases in each group.Routine nursing group was treated with the routine nursing mode；while，Pathway nursing group accepted treatment of the pathway nursing model.The repeated establishmentof venous channel，phlebitis，shock，incidence of adverse reaction in the process of nursing，pre-and post-nursing detection(5 d and 10 d after nursing) of the serum albumin (ALB) and hemoglobin (HB) levels were recorded；and the nutritional status of both groups were evaluated 10 daysafter nursing.Results The repeated establishment rate of venous channel，phlebitis，the incidence of shock，infection，diarrheaand vomiting of pathwaynursing groupwere significantly lower than those of routine nursing group (P<0.05)；compared with the preoperative care，the ALB and Hb levels of both groups significantly increased (P<0.01) and the ALB and Hb levels of pathway nursing group were significantly higher than those of routine nursing group (P<0.05)；10 days after nursing，the nitrogen balance value(0.88±0.10) of pathway nursing group was significantly higher than that of routine nursing group (0.56±0.08) (t=14.57， P=0.000).Conclusion Application of pathway nursing in infusion and nutrition for emergency treatment of patients with severe burn can significantly improve patients′ nutritional status，reduce the incidence of adverse reactions，and improve the prognosis of patients with severe burn.
[Key words]Pathway nursing；Severe burn；Emergency treatment
重症烧伤患者由于大面积的烧伤增加了机体代谢与能量消耗，加之机体抵抗力急剧下降，极易并发感染和多器官功能损伤，若处理不及时或治疗不当，会造成较高的死亡率[1]。重症烧伤治疗期间需要及时补充大量的电解质和能量，给予足够的营养支持，以免造成电解质紊乱，危及患者生命。临床路径可以根据患者不同临床情况制定个体化、标准化和流程化的诊疗和护理方案，而被广泛应用于临床[2-3]，我院采用路径护理模式，在重症烧伤患者急救期的输液及营养护理过程中取得较好的临床效果，现报道如下。 (谢茜宇)