认知干预在抗结核药物致肝损伤患者中的应用效果

Application effect of cognitive intervention in patients with liver injury caused by antituberculous drugs

目的探讨认知干预在抗结核药物致肝损伤患者中的应用效果。方法选取2020年4月至2021年4月厦门大学附属第一医院收治的87例抗结核治疗致药物性肝损伤患者作为研究对象,采用随机数字表法将其分为对照组(43例)和观察组(44例)。对照组患者采用常规护理,观察组患者采用认知干预。比较两组患者干预前后焦虑、抑郁情况及对药物致肝损伤(DILI)相关知识知晓情况,护理6个月后观察两组患者痰涂片转阴率、肺部病灶吸收情况。结果干预前,两组患者组间焦虑自评量表(SAS)、抑郁自评量表(SDS)评分比较,差异无统计学意义(P>0.05);干预后,观察组SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05)。干预前,两组患者DILI相关知识知晓评分比较,差异无统计学意义(P>0.05);干预后,观察组DILI相关知识知晓评分高于对照组,差异有统计学意义(P<0.05)。连续干预6个月,观察组X线肺部病灶吸收效率(88.37%)高于对照组(72.09%),差异有统计学意义(P<0.05)。两组患者的痰涂片转阴率比较,差异无统计学意义(P>0.05)。结论抗结核药物致肝损伤患者实施认知干预能够提升短期的临床疗效,改善患者的负面情绪及其对抗结核药物治疗相关知识的了解。

Objective To explore the effect of cognitive intervention in patients with liver injury caused by anti-tuberculosis drugs.Methods A total of 87 patients with drug-induced liver injury caused by anti-tuberculosis treatment from April 2020 to April 2021 were selected as the research objects,they were divided into the control group(43 cases)and the observation group(44 cases)according to random number table method.The patients in the control group received routine nursing,and patients in the observation group received cognitive intervention.The anxiety,depression and drug-induced liver injury(DILI)related knowledge were compared between the two groups before and after the intervention.After 6 months of nursing,the negative rate of sputum smear and the absorption of lung lesions were compared in the two groups.Results There were no significant differences in the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)between the groups before the intervention(P>0.05).After the intervention,the SAS and SDS scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Before the intervention,there were no significant differences in the DILI-related knowledge awareness scores between the two groups(P>0.05).After the intervention,the DILI-related knowledge awareness scores in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).After continuous intervention for 6 months,the absorption efficiency of X-ray lung lesions in the observation group(88.37%)was higher than that in the control group(72.09%),and the difference was statistically significant(P<0.05).There was no significant difference in the sputum smear negative rate between the two groups(P>0.05).Conclusion Cognitive intervention in patients with liver injury caused by antituberculosis drugs can improve short-term clinical efficacy,negative emotion and knowledge of antituberculosis drug therapy.