摘要
目的探讨FAST HUGS BID管理模式对重症急性胰腺炎(SAP)患者的应用效果。方法将收入郴州市第四人民医院重症医学科(ICU)的SAP患者随机分为常规管理组(n=42)和FAST HUGS BID管理组(n=46),FAST HUGS BID管理组在常规治疗的基础上,引入FAST HUGS BID管理理念,包括营养支持(F)、镇痛(A)、镇静(S)、深静脉血栓预防(T)、床头抬高(H)、应激性溃疡预防(U)、血糖管理(G)、自主呼吸锻炼(S)、肠道评估(B)、导管评估(I)、抗生素降阶梯(D)。主要研究终点为90 d存活率和住ICU时间。结果 FAST HUGS BID管理组90 d存活率明显高于常规管理组(HR=0.290,95%CI=0.093~0.901,χ^(2)=3.914,P=0.048)。与常规管理组比较,FAST HUGS BID管理组住ICU时间(d)明显减少(12.34±6.37 vs. 9.53±4.32,t=2.440,P=0.017)。14、28 d FAST HUGS BID管理组感染指标和疾病严重程度优于常规管理组(P <0.05)。FAST HUGS BID管理组并发症发生率较常规管理组更低(32.61%vs. 57.14%,χ^(2)=5.734,P=0.017)。结论 FAST HUGS BID管理模式可提高SAP患者存活率,降低住院期间并发症,值得临床推广。
Objective To explore the effectiveness of applying FAST HUGS BID in the patients with severe acute pancreatitis( SAP). Methods Eligible patients in our department were divided into control group( n = 42) and FAST HUGS BID group( n = 46). FAST HUGS BID group accepted FAST HUGS BID management, including feeding( F), analgesia( A), sedation( S), thromboembolic prophylaxis( T),head of bed elevation( H),ulcer prophylaxis( U),glycemic control( G),spontaneous breathing trial( S),bowel regimen( B),indwelling catheter removal( I),de-escalation of antibiotics( D). The primary endpoint was 90-day survival rate and length of ICU stay. Results In FAST HUGS BID group,the 90-day survival rate were higher than in the control group( HR = 0. 290,95% CI =0. 093-0. 901,χ^(2)= 3. 914,P = 0. 048). The length of ICU stay was less in FAST HUGS BID group than in the control group( d: 12. 34 ± 6. 37 vs. 9. 53 ± 4. 32,t = 2. 440,P = 0. 017). The indicators of infection and the severity of illness were better in FAST HUGS BID group than in the control group( P <0. 05). The complications was less in FAST HUGS BID group than in the control group( 32. 61% vs. 57. 14%,χ^(2)= 5. 734,P = 0. 017). Conclusions Applying FAST HUGS BID in the patients with SAP can improve the survival rate,decrease the incidence of complications,and is worth popularizing.
作者
赵阳
李志庆
雷小玲
戴新贵
Zhao Yang;Li Zhi-qing;Lei Xiao-ling;Dai Xin-gui(Department of Critical Care Medicine y the Fourth People’s Hospital of Chenzhou,Chenzhou 423000,China)
出处
《中国急救医学》
CAS
CSCD
2021年第8期665-668,共4页
Chinese Journal of Critical Care Medicine
基金
国家自然科学基金项目(81601708)
湖南省卫健委科研项目(B2016200)。
作者简介
赵阳(1985-),女,硕士,主治医师,E-mail:zhaoyang235@sina.cn;通信作者:戴新贵(1981-),男,博士后,教授,主任医师,硕士生导师,重症医学科副主任,E-mail:dyce@2008.sina.com。
