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目的探讨急救护理方案应用于肿瘤并发多器官功能障碍综合征(MODS)患者的临床效果。方法选取2014年6月至2016年6月间攀枝花市中西医结合医院收治的116例肿瘤并发MODS患者,采用随机数字表法分为研究组与对照组,每组58例。对照组采用对症支持治疗、连续性肾脏替代治疗(CRRT)及常规急救护理措施,研究组患者在对照组基础上应用综合急救护理干预。采用急性生理与慢性健康评分(APACHEⅡ)对比两组患者急救0h与12h后病情变化,两组患者急救后7d与21d的死亡率,调查两组护理满意度。结果研究组患者急救12h后APACHEⅡ评分为(17.5±6.5)分,低于对照组的(23.8±4.5)分,两组比较差异有统计学意义(P<0.05)。研究组患者急救后7d和21d的死亡率为1.7%和3.5%,与对照组的3.5%和6.9%比较差异均无统计学意义(均P>0.05)。研究组患者护理满意率为100.0%,高于对照组的89.7%,两组比较差异有统计学意义(P<0.05)。结论综合急救护理方案在肿瘤并发MODS患者中具有显著的应用效果,能有效改善预后,提高护理满意度。
Objective To investigate the clinical effect of emergency nursing program on patients with tumor complicated with multiple organ dysfunction syndrome (MODS). Methods One hundred and sixty-six patients with MODS who were admitted to the Integrative Medicine Hospital of Panzhihua City from June 2014 to June 2016 were randomly divided into study group and control group with 58 cases in each group. The control group received symptomatic supportive care, continuous renal replacement therapy (CRRT) and routine first-aid nursing intervention. The study group was given comprehensive emergency nursing intervention on the basis of the control group. Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ) were used to compare the changes of the two groups after 0h and 12h after emergency treatment. The mortality rates of the two groups after 7d and 21d after emergency were compared. Results The APACHE Ⅱ score of the study group was (17.5 ± 6.5) after 12 hours of emergency treatment, which was lower than that of the control group (23.8 ± 4.5). There was significant difference between the two groups (P <0.05). The mortality rates of study group 7 and 21 days after first aid were 1.7% and 3.5%, respectively, which were not significantly different from 3.5% and 6.9% of those in control group (all P> 0.05). The satisfaction rate of nursing in study group was 100.0%, which was higher than that in control group (89.7%). The difference between the two groups was statistically significant (P <0.05). Conclusion The comprehensive first-aid nursing program has significant application effects in patients with tumor complicated with MODS, which can effectively improve prognosis and improve nursing satisfaction.