优质护理对乙型肝炎后肝硬化伴上消化道出血的治疗辅助作用研究
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摘要
目的:探讨优质护理对乙型肝炎后肝硬化伴上消化道出血治疗的辅助作用。方法:选取2016年5月-2017年5月本院收治的乙型肝炎后肝硬化伴上消化道出血患者86例。按照随机数字表法将其分为对照组和研究组,各43例。两组均接受针对性治疗,然后在此基础上对照组应用常规护理干预,研究组应用优质护理干预。比较两组止血时间、出血量以及住院时间、心理状态(SAS、SDS)干预效果及满意度。结果:研究组出血量、出血时间均少于对照组(P<0.05),但住院时间长于对照组(P<0.05);研究组总满意率为93.0%,高于对照组的74.4%(P<0.05);干预后,研究组SAS、SDS评分均低于对照组(P<0.05);研究组总有效率为93.0%,高于对照组的76.7%(P<0.05)。结论:在乙型肝炎后肝硬化伴上消化道出血过程当中,采用优质护理进行辅助治疗可以有效提高干预效果,促进患者康复,提高患者满意度,临床上应当进一步推广应用。
Objective:To explore the auxiliary effect of high quality nursing on the treatment of cirrhosis after hepatitis b with upper gastrointestinal bleeding.Method:A total of 86 patients with cirrhosis after hepatitis b with upper gastrointestinal bleeding from May 2016 to May 2017 in our hospital were selected.According to the random number table method,they were divided into control group and study group,43 cases in each group.Both groups received targeted treatment,and on this basis,the control group was given routine nursing intervention,while the study group was given high quality nursing intervention.The time of hemostasis,the amount of bleeding,the length of hospitalization,the effect of psychological state(SAS,SDS)intervention and satisfaction between two groups were compared.Result:The amount of bleeding and the time of bleeding in study group were less than those of control group(P<0.05),but the length of hospitalization was longer than that of control group(P<0.05).The total satisfaction rate of study group was93.0%,which was higher than 74.4% of control group(P<0.05).After intervention,the SAS and SDS scores in study group were lower than those of control group(P<0.05).The total effective rate was 93.0%in study group,which was higher than 76.7% of control group(P<0.05).Conclusion:In the process of cirrhosis after hepatitis b with upper gastrointestinal bleeding,the use of high quality nursing can effectively improve the intervention effect,promote the rehabilitation of patients,improve patient satisfaction,clinical application should be further promoted.
Objective:To explore the auxiliary effect of high quality nursing on the treatment of cirrhosis after hepatitis b with upper gastrointestinal bleeding.Method:A total of 86 patients with cirrhosis after hepatitis b with upper gastrointestinal bleeding from May 2016 to May 2017 in our hospital were selected.According to the random number table method,they were divided into control group and study group,43 cases in each group.Both groups received targeted treatment,and on this basis,the control group was given routine nursing intervention,while the study group was given high quality nursing intervention.The time of hemostasis,the amount of bleeding,the length of hospitalization,the effect of psychological state(SAS,SDS)intervention and satisfaction between two groups were compared.Result:The amount of bleeding and the time of bleeding in study group were less than those of control group(P<0.05),but the length of hospitalization was longer than that of control group(P<0.05).The total satisfaction rate of study group was93.0%,which was higher than 74.4% of control group(P<0.05).After intervention,the SAS and SDS scores in study group were lower than those of control group(P<0.05).The total effective rate was 93.0%in study group,which was higher than 76.7% of control group(P<0.05).Conclusion:In the process of cirrhosis after hepatitis b with upper gastrointestinal bleeding,the use of high quality nursing can effectively improve the intervention effect,promote the rehabilitation of patients,improve patient satisfaction,clinical application should be further promoted.
引文
[1]张蕾,王勇,李华龙,等.乙型肝炎肝硬化伴上消化道出血患者医院感染因素分析[J].中华医院感染学杂志,2016,26(17):3903-3905.
[2]朱艳萍,胡欣欣,袁灵,等.核苷(酸)类似物抗病毒治疗对乙型肝炎肝硬化相关并发症的影响研究进展[J].山东医药,2017,57(41):94-97.
[3]Sung J J,Tang R S,Ching J Y,et al.The use of capsule endoscopy in the emergency department as a triage of patients with GI bleeding[J].Gastrointest Endosc,2016,84(6):907-913.
[4]杨美荣,邓莉莉,刘斌,等.生长抑素联合丹参治疗肝硬化并发上消化道出血与门静脉血栓形成的临床研究[J].中国现代医学杂志,2017,27(13):63-66.
[5]张铠,赵卫.TIPS联合胃冠状静脉栓塞治疗肝硬化门静脉高压伴上消化道出血[J].介入放射学杂志,2017,26(7):601-606.
[6]Joy P S,Kumar G,Guddati A K,et al.Risk Factors and Outcomes of Gastrointestinal Bleeding in Left Ventricular Assist Device Recipients[J].Am J Cardiol,2016,117(2):240-244.
[7]蒋丽琳,肖南平,陆俊伶.奥曲肽联合不同剂量垂体后叶素治疗血吸虫性肝硬化继发上消化道出血的应用研究[J].中国地方病防治杂志,2016,36(4):380-381.
[8]袁超,吴文平.鼻饲通腑泻热合剂治疗肝硬化上消化道出血后肝昏迷患者20例[J].南京中医药大学学报,2016,32(6):598-600.
[9]梁文京,符应田,黎燕锋,等.内镜下套扎联合药物注射治疗肝硬化合并上消化道出血的疗效[J].实用医学杂志,2016,32(12):2017-2019.
[10]殷燕,李捷壮,聂尚燕.恩替卡韦与阿德福韦酯治疗乙型病毒性肝炎失代偿性肝硬化患者的临床研究[J].中国临床药理学杂志,2016,32(18):1639-1642.
[11]薛伟红,王友春,韩宏锋,等.肝硬化合并上消化道出血患者医院感染的相关因素分析[J].中华医院感染学杂志,2017,27(14):3204-3207.
[12]Robertson M,Majumdar A,Boyapati R,et al.Risk stratification in acute upper GI bleeding:comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems[J].Gastrointest Endosc,2016,83(6):1151-1160.
[13]朱艳华,王运华.伴严重心血管病的甲状腺肿瘤患者实施优质护理干预的作用分析[J].中华肿瘤防治杂志,2016,23(S2):334-335.
[14]Haddara S,Jacques J,Lecleire S,et al.A novel hemostatic powder for upper gastrointestinal bleeding:a multicenter study(the“GRAPHE”registry)[J].Endoscopy,2016,48(12):1084-1095.
[15]周嘉宁,魏志,孙自勤.肝硬化食管静脉曲张套扎后早期再出血相关危险因素的多中心研究[J].中华肝脏病杂志,2016,24(7):486-492.
[16]潘素荣,胡俊红,张玉梅,等.预防性应用抗菌药物对肝硬化消化道出血患者医院感染的影响研究[J].中华医院感染学杂志,2016,26(4):755-757.
[17]Penson D F.Re:Better Patient Care at High-Quality Hospitals May Save Medicare Money and Bolster Episode-Based Payment Models[J].The Journal of Urology,2017,197(5):1338-1339.
[18]纪昌学,李瀛,鞠帅,等.经皮穿脾食管胃底静脉栓塞术治疗血吸虫病上消化道出血[J].中国血吸虫病防治杂志,2017,29(3):349-351.
[19]杨小艳,郭传勇,张旭,等.维生素C联合奥曲肽治疗肝硬化消化道出血的预后及血清胆碱酯酶和氧化应激水平变化研究[J].中国全科医学,2018,21(4):439-443.
[20]黄丽华.探讨优质护理相关措施在急诊外伤患者处置过程中的应用方法与效果[J].中国医学创新,2016,13(28):89-91.
[2]朱艳萍,胡欣欣,袁灵,等.核苷(酸)类似物抗病毒治疗对乙型肝炎肝硬化相关并发症的影响研究进展[J].山东医药,2017,57(41):94-97.
[3]Sung J J,Tang R S,Ching J Y,et al.The use of capsule endoscopy in the emergency department as a triage of patients with GI bleeding[J].Gastrointest Endosc,2016,84(6):907-913.
[4]杨美荣,邓莉莉,刘斌,等.生长抑素联合丹参治疗肝硬化并发上消化道出血与门静脉血栓形成的临床研究[J].中国现代医学杂志,2017,27(13):63-66.
[5]张铠,赵卫.TIPS联合胃冠状静脉栓塞治疗肝硬化门静脉高压伴上消化道出血[J].介入放射学杂志,2017,26(7):601-606.
[6]Joy P S,Kumar G,Guddati A K,et al.Risk Factors and Outcomes of Gastrointestinal Bleeding in Left Ventricular Assist Device Recipients[J].Am J Cardiol,2016,117(2):240-244.
[7]蒋丽琳,肖南平,陆俊伶.奥曲肽联合不同剂量垂体后叶素治疗血吸虫性肝硬化继发上消化道出血的应用研究[J].中国地方病防治杂志,2016,36(4):380-381.
[8]袁超,吴文平.鼻饲通腑泻热合剂治疗肝硬化上消化道出血后肝昏迷患者20例[J].南京中医药大学学报,2016,32(6):598-600.
[9]梁文京,符应田,黎燕锋,等.内镜下套扎联合药物注射治疗肝硬化合并上消化道出血的疗效[J].实用医学杂志,2016,32(12):2017-2019.
[10]殷燕,李捷壮,聂尚燕.恩替卡韦与阿德福韦酯治疗乙型病毒性肝炎失代偿性肝硬化患者的临床研究[J].中国临床药理学杂志,2016,32(18):1639-1642.
[11]薛伟红,王友春,韩宏锋,等.肝硬化合并上消化道出血患者医院感染的相关因素分析[J].中华医院感染学杂志,2017,27(14):3204-3207.
[12]Robertson M,Majumdar A,Boyapati R,et al.Risk stratification in acute upper GI bleeding:comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems[J].Gastrointest Endosc,2016,83(6):1151-1160.
[13]朱艳华,王运华.伴严重心血管病的甲状腺肿瘤患者实施优质护理干预的作用分析[J].中华肿瘤防治杂志,2016,23(S2):334-335.
[14]Haddara S,Jacques J,Lecleire S,et al.A novel hemostatic powder for upper gastrointestinal bleeding:a multicenter study(the“GRAPHE”registry)[J].Endoscopy,2016,48(12):1084-1095.
[15]周嘉宁,魏志,孙自勤.肝硬化食管静脉曲张套扎后早期再出血相关危险因素的多中心研究[J].中华肝脏病杂志,2016,24(7):486-492.
[16]潘素荣,胡俊红,张玉梅,等.预防性应用抗菌药物对肝硬化消化道出血患者医院感染的影响研究[J].中华医院感染学杂志,2016,26(4):755-757.
[17]Penson D F.Re:Better Patient Care at High-Quality Hospitals May Save Medicare Money and Bolster Episode-Based Payment Models[J].The Journal of Urology,2017,197(5):1338-1339.
[18]纪昌学,李瀛,鞠帅,等.经皮穿脾食管胃底静脉栓塞术治疗血吸虫病上消化道出血[J].中国血吸虫病防治杂志,2017,29(3):349-351.
[19]杨小艳,郭传勇,张旭,等.维生素C联合奥曲肽治疗肝硬化消化道出血的预后及血清胆碱酯酶和氧化应激水平变化研究[J].中国全科医学,2018,21(4):439-443.
[20]黄丽华.探讨优质护理相关措施在急诊外伤患者处置过程中的应用方法与效果[J].中国医学创新,2016,13(28):89-91.