重型肝炎预后因素分析与护理对策  

Severe hepatitis:prognostic factors and nursing interventions

作　　者：罗玲[1] 袁春兰[1] 赖宁[1] 蒋祖利[1] 林年芬[1] 汪景香[1] 

机构地区：[1]重庆医科大学第二临床学院感染病科,重庆市400010

出　　处：《世界华人消化杂志》2011年第19期2068-2071,共4页World Chinese Journal of Digestology

基　　金：重庆医科大学校办课题基金资助项目;No.Xbyb2008030~~

摘　　要：目的:研究重型肝炎预后的影响因素,从中筛选出对预后有明显影响的因素,并探讨其与预后的相关程度,为护理干预提供依据.方法:将重庆医科大学附属第二医院感染病科2007-01/2010-06所收治201例重型肝炎患者分为治疗有效组和治疗无效组,分别从年龄、性别、临床分型、病原分型、并发症、既往病史、生化指标等方面进行回顾性研究,借助SPSS软件进行Logistic回归分析,确定这些因素与重型肝炎预后的相关程度.结果:年龄、临床分型、肝性脑病、电解质紊乱、原发性腹膜炎、酸碱失衡、肝肾综合征、胃肠道出血、既往肝硬化基础、PTA、总胆红素、尿素氮、肌酐、血钠等指标与预后有明显的关系(均P<0.01).PTA、尿素氮、血钠、肝性脑病为影响预后的独立危险因素,构成预后评分系统,预后评分=10×(1.082×肝性脑病分值+0.944×尿素氮分值+0.915×血钠分值+0.593×PTA分值).结论:PTA、尿素氮、血钠、肝性脑病作为独立的危险因素可用于判断患者的预后,使临床护理更有针对性和目的性.AIM：To determine factors that can significantly influence the prognosis of severe hepatitis and to establish an prognostic assessment system to provide a basis for nursing interventions. METHODS：Two hundred and one patients with severe hepatitis who were treated from January 2007 to June 2010 at our hospital were included in this study.These patients were divided into two groups：patients with a positive treatment response and those with a negative response. Factors including age,sex,clinical type,pathogen type,complications,past history,and biochemical indexes were analyzed retrospectively. The correlation between these factors and prognosis of severe hepatitis was estimated by logistic regression analysis. RESULTS：Factors that could significantly influence the prognosis of severe hepatitis include age,clinical type,hepatic coma and TB（all P 0.01）.Logistic regression analysis demonstrated that PTA,urea,blood sodium and hepatic coma were independent prognostic factors for severe hepatitis.We used these factors to develop a prognostic scoring system：prognosis score=10 ×（1.082×hepatic encephalopathy score＋0.944 ×BUN score＋0.915×blood sodium score＋0.593 ×PTA score）. CONCLUSION：PTA,urea,blood sodium and hepatic coma are independent prognostic factors for severe hepatitis and can be used to evaluate the prognosis of the disease.The scoring system we developed is very effective to evaluate prognosis of severe hepatitis.

关 键 词：重型肝炎 预后 因素分析 护理 

分 类 号：R473.5[医药卫生—护理学]