胃肠炎患者补液策略与急诊留观时间的相关性分析

Correlation Analysis of Fluid Replacement Strategies for Gastroenteritis Patients and Their Emergency Observation Time

摘要: 目的：探讨胃肠炎患者不同补液策略与急诊留观时间的相关性，为优化急诊护理方案提供依据。方法：回顾性分析2022年1月1日至2025年12月31日本院急诊科收治的80例胃肠炎患者的临床资料，根据补液量分为(249.999, 406.0]组(20例)、(406.0, 550.0]组(23例)、(550.0, 750.0]组(19例)和(750.0, 2450.0]组(18例)，比较各组留观时间、症状缓解时间及72h再就诊率，并分析补液量与留观时间的相关性。结果：四组患者留观时间分别为(3.29 ± 1.30) h、(3.30 ± 1.09) h、(4.57 ± 1.25) h和(5.17 ± 2.93) h，差异有统计学意义(F = 5.688, P = 0.001)；两两比较显示，(750.0, 2450.0]组留观时间显著长于(249.999, 406.0]组和(406.0, 550.0]组(均P < 0.01)，(550.0, 750.0]组亦显著长于前两组(P < 0.05)。呕吐停止时间和腹泻停止时间组间差异均无统计学意义(P > 0.05)。补液量与留观时间呈显著正相关(r = 0.661, P < 0.001)，回归方程为：留观时间(h) = 1.538 + 0.004 × 补液量(ml)，R² = 0.438。72 h再就诊率组间差异无统计学意义(χ² = 1.784, P = 0.618)。多元回归分析显示补液量是留观时间的独立影响因素(B = 0.004, β = 0.645, t = 7.519, P < 0.001)。结论：胃肠炎患者的补液量与急诊留观时间呈显著正相关，这一关联可能反映了病情相对更重的患者往往需要更多补液支持，同时也需要更长的急诊观察与评估时间；本研究结果暂不支持直接通过控制补液量缩短留观时间的因果推断，仍需结合临床实际个体化决策。

Abstract: Objective: This paper aims to explore the correlation between different fluid replacement strategies for patients with gastroenteritis and the duration of emergency observation, and to provide a basis for optimizing the emergency nursing plan. Methods: The clinical data of 80 patients with gastroenteritis admitted to the emergency department of our hospital from January 1, 2022 to December 31, 2025 were retrospectively analyzed. The patients were divided into four groups based on the fluid replacement volume: (249.999, 406.0] group (20 cases), (406.0, 550.0] group (23 cases), (550.0, 750.0] group (19 cases), and (750.0, 2450.0] group (18 cases). The observation time, symptom relief time, and 72-hour re-visit rate were compared among the groups, and the correlation between fluid replacement volume and observation time was analyzed. Results: The observation times of the four groups were (3.29 ± 1.30) h, (3.30 ± 1.09) h, (4.57 ± 1.25) h, and (5.17 ± 2.93) h, respectively. The differences were statistically significant (F = 5.688, P = 0.001); pairwise comparisons showed that the observation time of the (750.0, 2450.0] group was significantly longer than that of the (249.999, 406.0] group and the (406.0, 550.0] group (both P < 0.01), and the (550.0, 750.0] group was also significantly longer than the former two groups (P < 0.05). There were no statistically significant differences in the time of vomiting cessation and diarrhea cessation among the groups (P > 0.05). The fluid replacement volume was significantly positively correlated with the observation time (r = 0.661, P < 0.001), and the regression equation was: observation time (h) = 1.538 + 0.004 × fluid replacement volume (ml), R² = 0.438. There were no statistically significant differences in the 72-hour revisit rate among the groups (χ² = 1.784, P = 0.618). Multivariate regression analysis showed that fluid replacement volume was an independent influencing factor for the observation time (B = 0.004, β = 0.645, t = 7.519, P < 0.001). Conclusion: The fluid intake of patients with gastroenteritis is significantly positively correlated with the duration of emergency observation. This correlation may reflect that patients with more severe conditions generally require more fluid support and also need a longer period of emergency observation and assessment; the results of this study do not currently support the causal inference that directly shortening the observation time can be achieved by controlling the fluid intake; individualized decisions based on clinical reality are still necessary.