综合护理干预在慢性乙型肝炎肝衰竭患者中的应用

Application of comprehensive nursing intervention in chronic hepatitis B patients with hepatic failure

目的探究与分析综合护理干预在慢性乙型肝炎肝衰竭患者中的应用。方法选取2012年3月～2016年3月中国医科大学附属第一医院收治的90例慢性乙型肝炎肝衰竭患者，按照就诊时间顺序将其分为常规护理组（2012年3月～2014年3月）与综合护理干预组（2014年4月～2016年3月），每组各45例。比较两组患者护理前后慢性乙型肝炎疾病相关知识的掌握情况，服药、定期复查依从性，焦虑抑郁评分及并发症发生率。结果护理后两组患者疾病相关知识掌握情况评分均较护理前明显提高，且综合护理干预组高于常规护理组，差异有统计学意义（P〈0．05）。与常规护理组比较，综合护理干预组忘记服药、自行增减药物服用剂量、自行停药患者比例较低，定期门诊复查患者比例较高，差异有统计学意义（P〈0．05）。护理后两组患者焦虑抑郁评分均较护理前降低，且综合护理干预组低于常规护理组，差异有统计学意义（P〈0．05）。综合护理干预组肝性脑病、消化道出血、肝肾综合征、继发感染发生率明显低于常规护理组，差异有统计学意义（P〈0．05）。结论综合护理干预可提高慢性乙型肝炎肝衰竭患者疾病相关知识的掌握程度及治疗依从性，降低并发症的发生，临床疗效显著，值得推广。

Objective To explore and analyze the effect of comprehensive nursing intervention in chronic hepatitis B patients with hepatic failure. Methods Ninety chronic hepatitis B patients with hepatic failure admitted to the First Hospital Affiliated to China Medical University from March 2012 to March 2016 were selected. All the patients were divided into conventional nursing group （from March 2012 to March 2014） and comprehensive nursing intervention group （from April 2014 to March 2016） according to the admission time sequence, with 45 cases in each group. The mastering conditions of chronic hepatitis B related knowledge, medication compliance, regular review compliance, the scores of anxiety and depression, and the incidence of compl!eations before and after nursing in the two groups were compared. Results The scores of mastering conditions of disease related knowledge of the two groups after nursing were all signif- icantly higher than those before nursing, and the score of comprehensive nursing intervention group was higher than that of conventional nursing group, with statistically significant differences （P 〈 0.05）. Compared with conventional nursing group, the rates of forgetting to take medicine, increasing or decreasing drug doses by oneself, drug withdrawal by oneself in the comprehensive nursing intervention group were lower, the rate of regular review was higher, with sta- tistically significant differences （P 〈 0.05）. The scores of anxiety and depression after nursing in the two groups were all lower than those before nursing, which of comprehensive nursing intervention group was lower than that of conventional nursing group, with statistically significant differences （P 〈 0.05）. The incidence of hepatic encephalopathy, gastroin- testinal bleeding, hepatorenal syndrome, secondary infection of comprehensive nursing intervention group was lower than those of conventional nursing group, with statistically significant differences （P 〈 0.05）. Conclusion Comprehensive nursing intervention can improve the mastering conditions of disease related knowledge and treatment compliance of chronic hepatitis B patients with hepatic failure, decrease the occurrence of complications, the clinical efficacy is distinct, which is worthy of promotion.