乙型肝炎肝硬化失代偿期患者对肝硬化并发症治疗常识的认知现况调查  

A cross-sectional survey on the cognition of common sense treatments on liver cirrhosis complications in decompensated patients with hepatitis B cirrhosis

作　　者：张俊霞[1] 闫杰[1] 魏阳[1] 王艳斌[1] 赵红[1] 王雪梅[1] 谢雯[1] 

机构地区：[1]首都医科大学附属北京地坛医院肝病一科,北京100015

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第3期100-103,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：北京市科委首都临床特色应用研究基金(No.Z131107002213020);北京市卫生系统高层次人才培养计划(No.2013-3-025)

摘　　要：目的从慢性疾病管理角度,调查乙型肝炎肝硬化失代偿期患者对肝硬化并发症治疗常识的认知现况及其影响因素,了解肝硬化并发症管理指南的实施状况和患者依从性,为进一步制定肝硬化并发症的二级预防策略和患者教育体系提供依据。方法对患者进行问卷调查,并通过查阅病历收集被调查者的人口学资料、病史以及反映疾病严重程度的指标(如Child-Pugh评分和MELD评分)后,采用SPSS 11.5软件进行统计分析,明确患者对肝硬化治疗常识的知晓率并探索其影响因素。结果知晓率最低的5个问题分别是:糖尿病患者可使用乳果糖治疗肝性脑病(12.3%)、腹水患者不需限制饮水量(16.9%)、可长期服用非选择性β受体阻滞剂预防食道胃底静脉曲张破裂出血(16.9%)、肝移植可治愈肝硬化(24.6%)、自发性细菌性腹膜炎是肝硬化的并发症(44.6%)。患者对肝硬化治疗常识的知晓率与年龄[<55岁者为(51.3±21.3)%,≥55岁者为(60.1±14.4)%,t=-2.813、P=0.006)],发现肝硬化时间[≥2年者为(66.5±13.1)%,<2年者为(47.9±18.6)%,t=-6.668、P<0.001)],住院次数[(≥2次者为(60.0±17.1)%,第一次住院者为(50.0±19.6)%,t=-3.101、P=0.002)]均显著相关,而与疾病严重程度无关。结论肝硬化患者对治疗常识的知晓率较低,尚需加强患者教育以提高其治疗依从性。Objective To assess the cognition and its influencing factors of common sense treatments on liver cirrhosis complications in decompensated hepatitis B cirrhosis patients; to investigate the implementation of the management guideline of hepatitis B cirrhosis complications and patient adherence; and to provide evidences for generating strategies for secondary prevention of the liver cirrhosis complications and patient education system. Methods A questionnaire survey was conducted in patients. Then the demographic data, disease history and some indicators reflecting the disease severity, such as Child-Pugh score and MELD score were collected, respectively. Data analysis was conducted by SPSS 11.5. Results The top 5 least understood facts, as follows, hepatic encephalopathy could be treated with lactulose in diabetes mellitus patients （12.3%）. Drinking shouldn＇t be restricted in liver cirrhosis patients with ascites （16.9%）. Gastro-esophageal varices bleeding could be prevented by long-term administration of non-selective 13-adrenergic receptor antagonists （16.9%）. Liver transplantation could cure liver cirrhosis （24.6%）. Spontaneous bacterial peritonitis was one kind of complications of liver cirrhosis （44.6%）. The rates of understandings of common sense treatments on liver cirrhosis complications were significantly related with age [〈 55 years old with （51.3 ± 21.3）% and 〉 55 years old with （60.1 ± 14.4）%; t = -2.813, P = 0.006） ], diagnosis duration of cirrhosis [/〉 2 years with （66.5 ± 13.1）% and 〈 2 years with （47.9 ± 18.6）%; t = -6.668, P 〈 0.001） ], hospitalization time （〉 2 years with （60.0 ± 17.1）% and 2 years with （50.0 ± 19.6）%;t =--3.101, P = 0.002）, but had no correlation with the severity of the disease. Conclusions The understanding rates of the common sense treatments on liver cirrhosis complications in patients with cirrhosis are very low. Therefore, it is important to improve the education of cirrhosis patients to increase their

关 键 词：肝炎 乙型 肝硬化 并发症治疗 现况调查 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]