耳穴揿针联合集束化护理在老年重症肺炎患者中的应用效果观察

doi:10.19983/j.issn.2096-8493.20260182

摘要/Abstract

摘要：

目的: 探讨耳穴揿针联合集束化护理在老年重症肺炎患者中的应用效果。方法: 采用前瞻性研究,纳入2023年10月至2025年12月甘肃省中医院收治的50例老年重症肺炎患者,按随机数字表法分为观察组与对照组,各25例。对照组实施常规护理;观察组在常规护理基础上给予耳穴揿针联合集束化护理干预,干预周期均为14d。分别于干预前、干预开始后第30天检测两组炎症指标[C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)]、血气指标[动脉血氧分压(arterial partial pressure of oxygen,PaO₂)、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO₂)、动脉血氧饱和度(arterial oxygen saturation,SaO₂)];干预第14天评价呼吸依从性;记录住院时间、重症监护室(intensive care unit,ICU)停留时间及28d再入院率。结果: 干预30d后,观察组CRP水平为(8.55±1.09)μg/L,IL-6水平为(15.38±4.52)pg/ml,均明显低于对照组[分别为(10.56±1.04)μg/L和(24.93±5.88)pg/ml],差异均有统计学意义(t=6.670、6.438,P值均<0.001)。干预14d后,观察组完全依从者占64.0%(16/25)、部分依从者占36.0%(9/25);对照组完全依从者占40.0%(10/25)、部分依从者占40.0%(10/25)、不依从者占20.0%(5/25),观察组依从性优于对照组,差异有统计学意义(Z=6.437,P=0.040)。干预30d后,观察组PaO₂[(70.69±1.03)mmHg(1mmHg=0.133kPa)]、SaO₂[(95.66±1.03)%]均明显高于对照组[分别为(52.66±1.02)mmHg、(88.39±1.06)%];观察组PaCO₂[(37.56±3.05)mmHg]明显低于对照组[(39.52±2.04)mmHg],差异均有统计学意义(t=62.190、24.593、2.670,P值均<0.001)。观察组住院时间[(14.23±2.15)d]明显短于对照组[(18.56±3.21)d],差异有统计学意义(t=-5.604,P<0.001);ICU停留时间[(5.12±1.56)d]明显短于对照组[(8.78±2.34)d],差异有统计学意义(t=-6.507,P<0.001);28d再入院率(4.0%,1/25)明显低于对照组(24.0%,6/25),差异有统计学意义(χ²=4.153,P=0.042)。结论: 耳穴揿针联合集束化护理可有效抑制老年重症肺炎患者炎症反应,提升呼吸依从性,缩短住院及 ICU 停留时间,降低再入院风险。

关键词: 老年护理学, 肺炎, 针刺穴位, 穴位按压, 对比研究

Abstract:

Objective: To explore the application effect of auricular point pressing-needle therapy combined with cluster nursing in elderly patients with severe pneumonia. Methods: A prospective study was conducted. A total of 50 elderly patients with severe pneumonia admitted to Gansu Provincial Hospital of Traditional Chinese Medicine from October 2023 to December 2025 were enrolled and divided into the observation group and the control group by the random number table method, with 25 cases in each group. The control group received routine nursing, while the observation group received auricular point pressing-needle therapy combined with cluster nursing intervention on the basis of routine nursing for an intervention period of 14 days. Inflammatory indicators including C-reactive protein (CRP) and interleukin-6 (IL-6), as well as blood-gas indicators including arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂) and arterial oxygen saturation (SaO₂) were detected before intervention and on the 30th day after intervention initiation. Respiratory compliance was evaluated on the 14th day of intervention. Length of hospital stay, intensive care unit (ICU) stay duration and 28-day readmission rate were recorded. Results: After 30-day intervention, the levels of CRP ((8.55±1.09) μg/L) and IL-6 ((15.38±4.52) pg/ml) in the observation group were significantly lower than those in the control group ((10.56±1.04) μg/L and (24.93±5.88) pg/ml, respectively), with statistically significant differences (t=6.670, 6.438, both P<0.001). On the 14th day of intervention, complete compliance and partial compliance accounted for 64.0% (16/25) and 36.0% (9/25) in the observation group; complete compliance, partial compliance and non-compliance accounted for 40.0% (10/25), 40.0% (10/25) and 20.0% (5/25) in the control group. The observation group showed better compliance than the control group, and the difference was statistically significant (Z=6.437, P=0.040). After 30-day intervention, PaO₂ ((70.69±1.03) mmHg, 1 mmHg=0.133 kPa) and SaO₂ ((95.66±1.03) %) in the observation group were significantly higher than those in the control group ((52.66±1.02) mmHg, (88.39±1.06) %); PaCO₂ ((37.56±3.05) mmHg) in the observation group was significantly lower than that in the control group ((39.52±2.04) mmHg), and the differences were statistically significant (t=62.190, 24.593, 2.670, all P<0.001). The length of hospital stay in the observation group ((14.23±2.15) d) was significantly shorter than that in the control group ((18.56±3.21) d; t=-5.604, P<0.001); the ICU stay duration ((5.12±1.56) d) was significantly shorter than that of the control group ((8.78±2.34) d; t=-6.507, P<0.001); the 28-day readmission rate was 4.0% (1/25), which was markedly lower than 24.0% (6/25) of the control group (χ²=4.153, P=0.042). Conclusion: Auricular point pressing-needle therapy combined with cluster nursing can effectively inhibit inflammatory response, improve respiratory compliance, shorten hospital and ICU stay duration, and reduce readmission risk in elderly patients with severe pneumonia.

Key words: Geriatric nursing, Pneumonia, Acupuncture points, Acupoint pressing, Comparative study

中图分类号:

R245
R473.5

潘丽琴, 寻晓珠. 耳穴揿针联合集束化护理在老年重症肺炎患者中的应用效果观察[J]. 结核与肺部疾病杂志,2026, 7(5): 643-647. doi: 10.19983/j.issn.2096-8493.20260182

Pan Liqin, Xun Xiaozhu. Observation on the application effect of auricular point pressing-needle combined with cluster nursing in elderly patients with severe pneumonia[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(5): 643-647. doi: 10.19983/j.issn.2096-8493.20260182

图/表 2

参考文献 14

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组别	C-反应蛋白(μg/L)		白细胞介素-6(pg/ml)
组别	干预前	干预后	干预前	干预后
观察组	13.14±1.96	8.55±1.09	29.45±6.43	15.38±4.52
对照组	12.45±1.39	10.56±1.04	29.44±6.32	24.93±5.88
t值	1.435	6.670	0.005	6.438
P值	0.157	<0.001	0.995	<0.010

组别	动脉血氧分压(mmHg)		动脉血二氧化碳分压(mmHg)		动脉血氧饱和度(%)
组别	干预前	干预后	干预前	干预后	干预前	干预后
观察组	46.85±10.52	70.69±1.03	34.53±1.05	37.56±3.05	78.52±1.04	95.66±1.03
对照组	46.63±10.55	52.66±1.02	34.55±1.01	39.52±2.04	78.56±1.52	88.39±1.06
t值	0.073	62.190	0.068	2.670	0.108	24.593
P值	0.941	<0.001	0.945	<0.001	0.914	<0.001

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