HBeAg阴性肝硬化患者抗病毒治疗的护理要点

Key points of nursing HBeAg negative cirrhotic patients with nucleot（s）ide analogues antiviral therapy

目的 探讨HBeAg阴性的乙型肝炎肝硬化患者接受核苷（酸）类似物治疗过程的护理要点.方法 将111例患者分为抗病毒组58例和对照组53例,抗病毒组在常规护肝治疗的基础上加用核苷（酸）类似物抗病毒治疗,对照组给予常规护肝治疗,对所有患者进行护理观察,总结护理要点.结果 除死亡8例外其余患者均完成96周治疗和随访,抗病毒组的ALT复常率和HBV DNA下降幅度均高于对照组,抗病毒组及对照组的HBV DNA转阴率（〈500拷/m1）分别为88.7%及32.5%,两组差异有统计学意义（x2=31.427,P=0.001）.结论 核苷（酸）类似物对HBeag阴性的肝硬化能有效抑制HBV复制,改善肝硬化患者肝功能.在治疗过程中做好疾病及药物知识宣教,建立良好的护患关系,强化患者的遵医行为,及时观察处理并发症,是治疗成功的关键.

Objective To explore the key points of nursing HBeAg negative cirrhotic patients with nucleot（S）ide analogues antiviral therapy.Method Patients enrolled into this study were divided into antiviral group（58 cases）and control group（53 cases）.Patients from control group only received the supportive and symptomatic treatment and those from antiviral group received the additional nucleot（s）ide analogues treatment.All patients were observed during hospitalization and were followed up in clinic.Finally,we would make a nursing assessment.Results All patients finished the 96-week treatment and follow-up,except 6 patients died. Alanine transferase normalization rate and HBV DNA decline were more remarkable in antiviral group than that in control group.HBV DNA negative（〈500 copies/ml）after 96-week treatment were 88.7% in antiviral group and 32.5% in control group respectively（X2=31.427.P=0.001）.Conclusion Nucleot（s）ide analogues are significantly effective to inhibit HBV DNA replication in HBeAg negative cirrhotic patients and improve liver function.The key points of nursing these patients including appropriate patients＇educating,benign nurse-patient relationship building,medical compliance emphasizing,and attentive complication observing and dealing.