原位肝移植受者术后症状群与症状困扰现状及其影响因素

Status quo of symptom groups and symptoms distress after orthotopic liver transplantation and its influencing factors

[目的]探讨肝脏移植受者症状群与症状困扰程度现状,并分析影响症状群和症状困扰的因素。[方法]选择2018年1月—2018年12月在南京鼓楼医院肝移植中心接受原位肝移植手术治疗的128例肝移植受者,采用一般资料调查表、中文版肝移植术后移植受者症状与症状困扰自评量表(MTSOSD)对128例肝移植受者进行问卷调查。[结果]肝移植受者存在情绪相关症状群、肝功能相关症状群、免疫抑制相关症状群3组症状群。性别、年龄、婚姻状况、文化程度、家庭人均月收入、医疗费用支付类型、肝功能Child分级、有无饮酒史是影响症状群的因素。年龄、性别、文化程度、婚姻状况、家庭人均月收入、医疗费用支付类型以及肝功能Child分级是影响肝移植受者症状困扰程度的主要因素。[结论]原位肝移植受者存在多种症状,且症状间相互协同、强化,提示医护人员应要由单一症状护理管理模式向症状群护理管理模式转变,采取有效的措施减轻肝移植受者的症状负担和症状困扰,以提高其术后生活质量。

Objective:To probe into the status quo of symptom groups and symptom gruops distress in liver transplant recipients,and to analyze its influencing factors.Methods:Totally 128 liver transplant recipients who underwent orthotopic liver transplantation at the Nanjing Drum Hospital Liver Transplantation Center from January 2018 to December 2018,were selected as subjects.Questionaire investigation was carried out by using the general information questionnaire and Modified Transplant Symptom Occurrence and Symptom Distress Scale(MTSOSD).Results:There were emotion related symptom group,liver function-related symptom group and immunosuppression related symptom group in liver transplant recipients.These factors,such as gender,age,marital status,educational level,family members average income per month,type of medical expenses,Child grade of liver function,and alcohol history,were main factors influencing symptoms of orthotopic liver transplantation recipients.Among above factors,recipients′age,sex,education level,marital status,family members average income per month,type of medical expenses and Child classification of liver function were main factors affecting the degree of symptoms distress.Conclusions:There are many symptoms in orthotopic liver transplantation recipients.And the symptoms are synergistic and strengthened each other.It is suggested that medical staff should transform from single symptom nursing management mode into symptoms groups centered nursing management mode,take effective measures to reduce the burden of symptoms and distress of liver transplant recipients,looking forward to improving the quality of life after surgery.