Fang Lan, Wang Mengmeng, Ye Xiaoling, Wu Jiehua, He Liang
Department of Emergency ICU, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Department of Emergency, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Medicine (Baltimore). 2025 May 2;104(18):e42013. doi: 10.1097/MD.0000000000042013.
This study aimed to assess the effects of systematic nursing on severe acute pancreatitis (SAP) patients undergoing continuous renal replacement therapy (CRRT). In this retrospective cohort study, data from SAP patients who received CRRT in our hospital's ICU from January 2022 to January 2024 were analyzed. Patients were grouped based on nursing care type: the experimental group (systematic nursing, 41 cases) and the control group (routine nursing, 59 cases). Observed indicators included vital sign stability, pain and anxiety scores, serum biochemical markers (serum amylase, C-reactive protein [CRP], and white blood cell count), complication rates, and nursing satisfaction. Propensity score matching was used to control for baseline differences. The experimental group demonstrated superior clinical outcomes compared to the control group, with significantly more stable body temperature (36.76 ± 0.31°C vs 37.05 ± 0.45°C, P = .036) and heart rate (82.1 ± 5.7 bpm vs 84.9 ± 6.6 bpm, P = .046). Pain (3.2 ± 1.1 vs 4.5 ± 1.3, P = .012) and anxiety scores (2.8 ± 0.9 vs 3.6 ± 1.0, P = .021) were also significantly lower. Inflammatory markers such as serum amylase (95.4 ± 30.2 vs 120.5 ± 35.8, P = .004), CRP (7.2 ± 3.1 vs 10.3 ± 3.5, P = .005), and white blood cell count (8.5 ± 2.0 vs 10.1 ± 2.6, P = .007) decreased significantly in the experimental group. Furthermore, the experimental group had lower complication rates than the control group (MODS incidence: 23.53% vs 73.53%, P = .030; infection rate: 29.41% vs 88.24%, P = .014; renal insufficiency incidence: 14.71% vs 58.82%, P = .026) and higher nursing satisfaction (P = .041). Systematic nursing significantly improved clinical outcomes in SAP patients receiving CRRT, enhancing vital sign stability, reducing pain and anxiety, controlling inflammation, decreasing complication rates, and increasing nursing satisfaction. These results support the use of systematic, individualized nursing in managing critically ill SAP patients.
本研究旨在评估系统性护理对接受连续性肾脏替代治疗(CRRT)的重症急性胰腺炎(SAP)患者的影响。在这项回顾性队列研究中,分析了2022年1月至2024年1月在我院重症监护病房接受CRRT的SAP患者的数据。根据护理类型对患者进行分组:实验组(系统性护理,41例)和对照组(常规护理,59例)。观察指标包括生命体征稳定性、疼痛和焦虑评分、血清生化标志物(血清淀粉酶、C反应蛋白[CRP]和白细胞计数)、并发症发生率和护理满意度。采用倾向得分匹配法控制基线差异。与对照组相比,实验组的临床结局更优,体温(36.76±0.31°C对37.05±0.45°C,P = 0.036)和心率(82.1±5.7次/分钟对84.9±6.6次/分钟,P = 0.046)明显更稳定。疼痛评分(3.2±1.1对4.5±1.3,P = 0.012)和焦虑评分(2.8±0.9对3.6±1.0,P = 0.021)也显著更低。实验组血清淀粉酶(95.4±30.2对120.5±35.8,P = 0.004)、CRP(7.2±3.1对10.3±3.5,P = 0.005)和白细胞计数(8.5±2.0对10.1±2.6,P = 0.007)等炎症标志物显著下降。此外,实验组的并发症发生率低于对照组(多器官功能障碍综合征发生率:23.53%对73.53%,P = 0.030;感染率:29.41%对88.24%,P = 0.014;肾功能不全发生率:14.71%对58.82%,P = 0.026),护理满意度更高(P = 0.041)。系统性护理显著改善了接受CRRT的SAP患者的临床结局,提高了生命体征稳定性,减轻了疼痛和焦虑,控制了炎症,降低了并发症发生率,并提高了护理满意度。这些结果支持在管理重症SAP患者时采用系统性、个性化护理。