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多模式干预方案预防老年危重症患者胃肠道手术后应激性溃疡的效果

Effectiveness of a multi-modal intervention protocol for preventing stress ulcers in critically ill older patients after gastrointestinal surgery.

作者信息

Xi Hai-Ming, Tian Man-Li, Tian Ya-Li, Liu Hui, Wang Yun, Chu Min-Juan

机构信息

Geriatric ICU, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China.

Department of Respiratory and Critical Care Medicine, Nanjing Central Hospital, Nanjing 210000, Jiangsu Province, China.

出版信息

World J Gastrointest Surg. 2025 Apr 27;17(4):100806. doi: 10.4240/wjgs.v17.i4.100806.

Abstract

BACKGROUND

Stress ulcers are common complications in critically ill patients, with a higher incidence observed in older patients following gastrointestinal surgery. This study aimed to develop and evaluate the effectiveness of a multi-modal intervention protocol to prevent stress ulcers in this high-risk population.

AIM

To assess the impact of a multi-modal intervention on preventing stress ulcers in older intensive care unit (ICU) patients postoperatively.

METHODS

A randomized controlled trial involving critically ill patients (aged ≥ 65 years) admitted to the ICU after gastrointestinal surgery was conducted. Patients were randomly assigned to either the intervention group, which received a multi-modal stress ulcer prevention protocol, or the control group, which received standard care. The primary outcome measure was the incidence of stress ulcers. The secondary outcomes included ulcer healing time, complication rates, and length of hospital stay.

RESULTS

A total of 200 patients (100 in each group) were included in this study. The intervention group exhibited a significantly lower incidence of stress ulcers than the control group (15% 30%, < 0.01). Additionally, the intervention group demonstrated shorter ulcer healing times (mean 5.2 7.8 days, < 0.05), lower complication rates (10% 22%, < 0.05), and reduced length of hospital stay (mean 12.3 15.7 days, < 0.05).

CONCLUSION

This multi-modal intervention protocol significantly reduced the incidence of stress ulcers and improved clinical outcomes in critically ill older patients after gastrointestinal surgery. This comprehensive approach may provide a valuable strategy for managing high-risk populations in intensive care settings.

摘要

背景

应激性溃疡是危重症患者常见的并发症,在老年患者胃肠道手术后的发生率更高。本研究旨在制定并评估一种多模式干预方案在这一高危人群中预防应激性溃疡的有效性。

目的

评估多模式干预对老年重症监护病房(ICU)患者术后预防应激性溃疡的影响。

方法

对胃肠道手术后入住ICU的危重症患者(年龄≥65岁)进行了一项随机对照试验。患者被随机分为干预组和对照组,干预组接受多模式应激性溃疡预防方案,对照组接受标准护理。主要结局指标是应激性溃疡的发生率。次要结局包括溃疡愈合时间、并发症发生率和住院时间。

结果

本研究共纳入200例患者(每组100例)。干预组应激性溃疡的发生率显著低于对照组(15%对30%,P<0.01)。此外,干预组溃疡愈合时间更短(平均5.2天对7.8天,P<0.05),并发症发生率更低(10%对22%,P<0.05),住院时间缩短(平均12.3天对15.7天,P<0.05)。

结论

这种多模式干预方案显著降低了老年危重症患者胃肠道手术后应激性溃疡的发生率,并改善了临床结局。这种综合方法可能为重症监护环境中高危人群的管理提供一种有价值的策略。

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