重症烧伤患者急救期输液及营养路径护理分析.docVIP

重症烧伤患者急救期输液及营养路径护理分析 　　[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（P0.05）；与护理前比较，护理后两组ALB、Hb水平均显著升高（P0.01），且路径护理组明显高于常规护理组（P0.05）；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 （P0.05）；compared with the preoperative care，the ALB and Hb levels of both groups significantly increased （P0.01） and the ALB and Hb levels of pathway nursing group were significantly higher than those of routine nursing group （P0.05）；10 days after nursing，the nitrogen balance value（0.88±0.10） of pathway nursing group was significantly higher than