个体化连续饮食护理在住院慢性乙型肝炎肝纤维化患者中的应用效果

Application of individualized continuous diet nursing in patients with chronic hepatitis B and hepatic fibrosis

目的探讨个体化连续饮食护理在住院慢性乙型肝炎肝纤维化患者中的应用效果。方法选取2015年1月—2017年5月于宁波市鄞州人民医院就诊的196例慢性乙型肝炎肝纤维化患者为研究对象。采用随机数字表法分为观察组和对照组,每组98例。入院后对照组和观察组患者均给予常规护理宣传教育。观察组患者给予个体化连续饮食护理干预。于饮食干预前和饮食干预后6个月收集患者各项资料,检测血清总胆红素(TBIL)、谷草转氨酶(AST)和谷丙转氨酶(ALT)水平,采用FibroScan检测肝纤维化程度,采用生活质量量表(SF-36)评价患者生活质量。结果干预前,2组TBIL、AST和ALT比较,差异无统计学意义(均P>0.05);干预后,观察组TBIL、AST和ALT显著降低(均P<0.05),且显著低于对照组(均P<0.05),对照组无明显变化。干预前,2组Stiffness值比较,差异无统计学意义(P>0.05);干预后,观察组Stiffness值显著降低(P<0.05),且显著低于对照组(P<0.05),对照组无明显变化。干预前,2组SF-36各维度得分比较,差异无统计学意义(均P>0.05);干预后,观察组SF-36各维度得分显著提高(均P<0.05),且显著高于对照组(均P<0.05),对照组无明显变化。结论连续的饮食护理有助于慢性乙型肝炎肝纤维化患者肝功能恢复和肝纤维化的逆转,同时可显著改善患者生活质量。

Objective To study the effect of individualized continuous dietary nursing in patients with chronic hepatitis B and liver fibrosis. Methods A total of 196 patients with chronic hepatitis B and liver fibrosis who were treated in our hospital from January 2015 to January 2017 were selected as the subjects. Patients were divided into observation group and control group with random table method. After admission, both groups were given routine nursing education. Patients in the observation group were given individualized continuous dietary care interventions. The levels of serum total bilirubin(TBIL), aspartate aminotransferase(AST) and alanine aminotransferase(ALT) were measured before and 6 months after diet intervention. FibroScan was used to detect the degree of hepatic fibrosis. Quality of life scale(SF-36) was used to evaluate the quality of life of patients. Results There was no significant difference in TBIL, AST and ALT between the two groups(all P>0.05) before intervention. After intervention, the levels of TBIL, AST and ALT in the observation group were significantly lower than those in the control group(all P<0.05). There was no significant change in the control group. There was no significant difference in stiffness value between the two groups(P>0.05). After intervention, the levels of stiffness value in the observation group were significantly lower than those in the control group(P<0.05). There was no significant change in the control group. There was no significant difference in SF-36 value between the two groups(all P>0.05) before intervention. After intervention, the score of SF-36 in the observation group were significantly higher than those in the control group(all P<0.05). There was no significant change in the control group. Conclusion Continuous dietary care can help restore liver function and liver fibrosis of patients with chronic hepatitis B liver fibrosis, and can improve the quality of life of patients.