小承气汤保留灌肠防治TIPS术后并发肝性脑病的护理观察

Nursing observation of Xiaochengqi decoction retention enema in prevention of complicated hepatic encephalopathy after TIPS

目的探讨小承气汤保留灌肠防治经颈静脉肝内门体分流术(TIPS)术后并发肝性脑病的护理效果。方法分析60例TIPS术患者的临床资料,依据是否给予针对保留灌肠护理措施进行分组,随机分为对照组(30例)和观察组(30例),对照组对于TIPS术患者给予纠正电解质失衡、控制感染等支持性护理措施,针对性的给予静脉滴注支链氨基酸,观察组在对照组治疗护理基础上在TIPS术后即采用小承气汤保留灌肠。观察两组临床效果。结果两组患者术前血氨、谷丙转氨酶、白蛋白、总胆红素和术后白蛋白比较,差异均无统计学意义(P>0.05),术后观察组血氨、谷丙转氨酶、总胆红素和肝性脑病发生率均优于对照组,差异均有统计学意义(P<0.05)。结论小承气汤保留灌肠可以有效的预防TIPS术后肝性脑病的发生率,提高患者预后水平。

Objective To investigate the nursing effect of Xiaochengqi decoction retention enema in prevention of complicated hepatic encephalopathy after transjugular intrahepatic portosystem stent-shunt (TIPS). Methods Clinical data of 60 TIPS patients were analyzed. They were divided into control group (30 cases) and observation group (30 cases) by retention enema measures. The control group received support nursing measure of electrolyte imbalance correcting and infection control with targeted branched chain amino acid by intravenous drip. The observation group received additional Xiaochengqi decoction after TIPS. Clinical effects of the two groups were observed. Results There were no statistically significant differences of preoperative blood ammonia, glutamic-pyruvic transaminase, albumin, total bilirubin, and postoperative albumin between the two groups (P>0.05). After treatment, the observation group had better blood ammonia, glutamic-pyruvic transaminase, total bilirubin, and incidence of hepatic encephalopathy than the control group, and the difference had statistical significance (P<0.05). Conclusion Xiaochengqi decoction retention enema can effectively prevent the incidence of hepatic encephalopathy after TIPS, and improve prognosis level in patients.