自我管理教育对拉米夫定治疗的慢性乙型肝炎患者健康行为及肝功能的影响

The self-management education on the influence on the health behavior and liver function of patients with chronic hepatitis B treated by Lamivudine

目的探讨自我管理教育对拉米夫定治疗的慢性乙型肝炎患者健康行为及肝功能的影响。方法将住院的102例HBeAg阳性、拉米夫定治疗的慢性乙型肝炎患者随机分成研究组和对照组各51例,对照组实施常规健康教育,研究组实施自我管理教育。分别在干预前及干预后1年对两组患者进行肝功能、乙型肝炎血清标志物、HBV DNA定量检测和知信行问卷调查。结果治疗前检测两组患者均为HBeAg阳性,ALT、HBV DNA定量比较差异无统计学意(P>0.05)。治疗后1年检测两组患者ALT、HBV DNA定量及HBeAg转阴率均较前有改善(P<0.05),研究组明显优于对照组(P<0.01)。教育1年后研究组的知识、态度、行为得分明显改善,与对照组比较差异有统计学意义(P<0.05)。结论自我管理教育督导了拉米夫定治疗的慢性乙型肝炎患者依从健康行为,可促进肝功能恢复,降低HBV DNA水平,提高HBeAg转阴率,改善健康状况。

Objective To explore the self-management education on the influence on the health behavior and liver function of patients with chronic hepatitis B treated by Lamivudine. Methods A total of 102 patients at hospital who were HBeAg positive were divided into study group and control group by random with each 51 cases, the control group were given routine health education, the study group were given self-management education. Two groups of patients were conducted a quantitative detection of liver function, hepatitis B serum markers, HBA DNA and a KAP survey respectively one year before intervention and after intervention. Results Before treatment, two groups of patients were HBeAg-positive, there was no significant difference in the comparison of quantitative detection of ALT, HBV and DNA between the two groups （P 〉 0.05）. One year after treatment, it was found that there was some improvement in quantitative ALT, HBV DNA and HBeAg negative rate than before（P 〈 0.05）, the study group was significantly better than the control group （P 〈 0.01）. One year after self-management education there was an obvious improvement in the score in their knowledge, attitude and behavior of the study group, there was significant difference comparing with control group （P 〈 0.05）. Conclusion Self-management education supervises patients with chronic hepatitis B to comply with the health behavior, promote the recovery of liver function, reduce BBV DNA levels, increase the HBeAg negative rate and improve their health.