肝功能衰竭患者胆红素吸附联合血浆置换治疗的护理干预  

Bilirubin adsorption nursing intervention on liver failure patients treated combined with plasma exchange

作　　者：王秀珍[1] 莫阔[1] 习丹[1] 刘琴[1] 梅青玲 

机构地区：[1]湖北省襄阳市中心医院(湖北文理学院附属医院)消化二科,湖北襄阳441021

出　　处：《中华医院感染学杂志》2016年第14期3345-3347,共3页Chinese Journal of Nosocomiology

基　　金：湖北省科学技术基金资助项目(201202305)

摘　　要：目的探讨联合应用胆红素吸附和血浆置换治疗肝功能衰竭患者的临床护理策略及效果,获取临床护理前瞻性研究数据。方法选取医院从2012年9月-2015年9月收治肝功能衰竭患者中抽取80例,根据就诊顺序将其随机分为干预组与对照组,各40例,对照组仅实施常规临床护理,干预组围绕临床治疗实施针对性的护理干预,统计干预前后两组的各项肝功能指标,并比较两组的症状改善率、护理有效率以及主要并发症情况。结果干预组腹胀、恶心、纳差等症状改善率均高于对照组,并发症总发生率要低于对照组,两组间对比差异有统计学意义(P<0.05);干预组护理有效率为97.5%与对照组护理有效率75.0%,差异有统计学意义(P<0.05);干预组的丙谷酸氨基转移酶(ALT)、凝血酶原时间(PT)、血清总胆红素(TBil)、白蛋白、天冬氨酸氨基转移酶(AST)以及凝血酶原活动度(PTA)等肝功能指标均明显优于对照组,差异有统计学意义(P<0.05);结论在肝功能衰竭的人工肝支持治疗过程中,需加强血管通路护理,术后给予患者科学的饮食和生活指导,以提高患者的基本生存质量。OBJECTIVE To study the clinical nursing strategies and effect of combined use of bilirubin adsorption and plasma exchange treatment for liver failure patients,so as to receive clinical nursing proactive study data.METHODS A total of 80 cases of patients with liver failure in our hospital from Sep.2012 to Sep.2015 were selected and divided into intervention group and control group according to the registration order,40 cases in each group.The control group only provided implementation of routine clinical care,but intervention group provided targeted nursing intervention on clinical treatment.Liver function indicators in two groups before and after the intervention were compared.The ameliorative rate of symptom,care efficiently and main complications were compared between two groups.RESULTS The symptoms in intervention group such as abdominal distension,nausea,anorexia were much better than those in control group,and the incidence of complications was lower than control group.The comparison between the two groups had significant difference（P〈0.05）;Intervention group（97.5%）of nursing efficient compared with the control group（75.0%）,which had significant difference（P〈0.05）.The ALT,AST,PT,TBil,albumin and PTA liver function index in intervention group were significantly better than those in control group（P〈0.05）.CONCLUSIONIn the process of artificial liver support therapy on liver failure,care for vascular access should be strengthened.Patients should be provided scientific diet and life guidance after operation,in order to improve the patient＇s basic quality of life.

关 键 词：肝功能衰竭 胆红素吸附 人工血浆置换 护理 并发症 

分 类 号：R457[医药卫生—治疗学]