精细护理对肝硬化并上消化道出血行食管静脉套扎治疗患者的影响研究

Effect of meticulous nursing on patients with liver cirrhosis complicated with upper gastrointestinal bleeding undergoing esophageal variceal ligation

目的观察并评价针对肝硬化合并上消化道出血进行食管静脉套扎的患者,精细护理干预对患者的效果。方法取我院2014年7月～2016年7月就诊的116例肝硬化合并上消化道出血患者,随机分两组,对照组(常规护理),观察组(精细护理),调查患者的观察指标(平均住院时间、止血成功、成功套扎、静脉明显变细、静脉曲张消失)、生存质量评分(生理、心理、环境、社会关系)及并发症发生情况(咽喉部疼痛、食管狭窄、胸骨后不适、再出血)及护理满意度。结果予以精细护理,观察组患者的平均住院时间减少明显,止血成功、成功套扎、静脉明显变细、静脉曲张消失的例数上升明显;观察组患者的生理、心理、环境、社会关系评分上升更明显;观察组患者的并发症发生率(6.90%,4/58)较对照组(17.24%,10/58)低,且观察组患者对护理满意度(94.83%,55/58)明显高于对照组(87.93%,51/58)高,差异具有统计学意义(P<0.05)。结论对于肝硬化合并上消化道出血进行食管静脉套扎的患者,精细护理干预的护理效果明显,有效减少了患者的平均住院时间,提高了止血和套扎的成功率,且提升了患者的生存质量,值得积极推广。

Objective To observe and evaluate the effect of meticulous nursing intervention on patients with cirrhosis combined with upper gastrointestinal bleeding undergoing esophageal variceal ligation. Methods 116 patients with cirrhosis complicated with upper gastrointestinal bleeding in our hospital from July 2014 to July 2016 were selected and randomly divided into two groups, the control group （routine nursing） and observation group （meticulous nursing）. The observation index of patients （average hospitalization time, hemostasis, successful ligation and thinning of vein and disappearance of varicose veins）, quality of life score （physiological, psychological, environmental and social relations） and the incidence of complications （throat pain, esophageal stenosis, chest pain, bleeding and nursing satisfaction） were investigated. Results After meticulous nursing, in the observation group, the average length of stay was significantly reduced, the number of successful hemostasis, successful ligation, vein thinning, varicose veins disappeared significantly, The number of patients with successful hemoslasis, successful ligation, thinning of vein and disappearance of varicose veins was significantly increased. The scores of physiological, psychological, environmental and social relations in the observation group increased more obviously; The cmnplication rate of the observation group （6.90%, 4/58） was lower than that of the control group （17.24%, 10/58）, And the nursing satisfaction of the observation group （94.83%, 55/58） was significantly higher than that of the control group （87.93%, 51/58）, The difference was significant （P 〈 0.05）. Conclusion The effect of meticulous nursing intervention on patients with liver cirrhosis complicated with upper gastrointestinal bleeding undergoing esophageal variceal ligation is obvious, which effectively reduce the average length of stay of patients, improve the success rate of hemostasis and libation and improve the quality of life of patients, it is worth promoting.