前瞻性护理在失代偿期肝硬化并发肝性脑病患者中的应用

Application of prospective nursing in patients with decompensated liver cirrhosis complicated with hepatic encephalopathy

目的探讨前瞻性护理在失代偿期肝硬化并发肝性脑病患者中的应用效果。方法选取东莞市滨海湾中心医院消化内科2016年12月至2018年12月间收治的101例失代偿期肝硬化并发肝性脑病患者作为研究对象,按照随机数表法将患者分为观察组50例和对照组51例。观察组患者采取前瞻性护理干预,对照组患者采取常规护理干预,比较两组患者干预后的总胆红素(TBIL)、谷丙转氨酶(ALT)、血氨(NH3)水平,以及患者意识障碍加重、肝性脑病再发和不良反应发生情况,同时采用自制调查问卷评测患者对护理的满意程度。结果护理干预后,观察组和对照组患者的TBIL[(35.2±3.7)mol/L vs(40.1±6.6)mol/L]、ALT[(81.6±7.4)U/L vs(89.4±21.8)U/L]、NH3[(34.9±3.4)mol/L vs(39.4±3.7)mol/L]水平比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的意识障碍加重率为10.0%,肝性脑病再发率为2.0%,明显低于对照组的17.6%、11.8%,差异均有统计学意义(P<0.05);观察组患者护理干预后的不良反应发生率为14.0%,明显低于对照组的37.3%,差异有统计学意义(P<0.05);观察组患者的护理总满意率为92.0%,明显高于对照组的82.4%,差异有统计学意义(P<0.05)。结论前瞻性护理干预有助于促进失代偿期肝硬化并发肝性脑病患者好转,降低患者不良反应发生率,提高患者满意度。

Objective To explore the effect of prospective nursing in patients with decompensated liver cirrhosis complicated with hepatic encephalopathy.Methods A total of 101 patients with decompensated cirrhosis complicated with hepatic encephalopathy admitted to the Department of Gastroenterology,Dongguan Binhai Bay Central Hospital from December 2016 to December 2018 were selected as the study objects.According to the random number table method,the patients were divided into observation group(50 cases)and control group(51 cases).The patients in the observation group received prospective nursing intervention,while the patients in the control group received routine nursing intervention.The levels of total bilirubin(TBIL),alanine aminotransferase(ALT),and blood ammonia(NH3)after intervention were compared between the two groups,as well as the aggravation of consciousness disorder,the recurrence of hepatic encephalopathy and the occurrence of adverse reactions.Results After nursing intervention,the levels of TBIL,ALT,NH3 in the observation group were significantly lower than those in the control group:TBIL,(35.2±3.7)mol/L vs(40.1±6.6)mol/L;ALT,(81.6±7.4)U/L vs(89.4±21.8)U/L;NH3,(34.9±3.4)mol/L vs(39.4±3.7)mol/L,P<0.05.The aggravation rate of consciousness disorder in the observation group was 10.0%,and the recurrence rate of hepatic encephalopathy was 2.0%,which were significantly lower than 17.6%,11.8%of the control group(P<0.05).The incidence of adverse reactions in the observation group was 14.0%,which was significantly lower than 37.3%in the control group(P<0.05).The total satisfaction rate of nursing in the observation group was 92.0%,which was significantly higher than82.4%in the control group(P<0.05).Conclusion Prospective nursing intervention can promote the improvement of patients with decompensated cirrhosis complicated with hepatic encephalopathy,reduce the incidence of adverse reactions,and improve patients’satisfaction.