乙肝相关性肾炎病人采用甲泼尼龙联合环孢素治疗的副作用随访及护理干预  

Side effects follow-up and nursing intervention experience of hepatitis b-associated nephritis patients treated with methylprednisolone combined with cyclosporine

作　　者：郝金翠 王晓玲[1] 王春燕[2] 宋君宇 胡秀红[4] HAO Jincui;WANG Xiaoling;WANG Chunyan;SONG Junyu;HU Xiuhong(Department of Nephrology,Harrison International Peace Hospital (Hengshui People’s Hospital),Hengshui,Hebei 053000,China;Department of Endocrine Nephropathy,Hengshui FourthPeople Hospital,Hengshui,Hebei 053000,China;Speen and Stomach Department ofTraditionol Chinese Medicine,Hengshui Traditional Chinese Medicine Hospital,Hengshui,Hebei 053000,China;Department of Nephrology,The First Hospital of Hebei MedicalUniversity,Shijiazhuang,Hebei 050000,China)

机构地区：[1]哈励逊国际和平医院(衡水市人民医院)肾内科,河北衡水053000 [2]衡水市第四人民医院内分泌肾病科,河北衡水053000 [3]衡水市中医院中医脾胃科,河北衡水053000 [4]河北医科大学第一医院肾内科,河北石家庄050000

出　　处：《安徽医药》2019年第5期1036-1039,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨定期随访及护理干预对激素联合环孢素治疗乙肝相关性肾炎后副作用及远期治疗效果的影响。方法选取2015年3月至2016年3月于哈励逊国际和平医院(衡水市人民医院)采用甲泼尼龙联合环孢素治疗的乙肝相关性肾炎62例,采用随机数字表法分为观察组(31例)与对照组(31例),对照组进行甲泼尼龙联合环孢素治疗、护肝、基础护理等,观察组在对照组的基础上加入饮食护理及心理护理,观察护理对治疗效果的影响,同时在病人治疗阶段进行电话随访,观察病人是否定期复诊、症状是否改善、是否出现并发症、出现并发症后是否及时治疗,共7次。比较病人每次复诊时检测的血常规、肝肾功能、清蛋白、血脂及24 h尿蛋白定量、HBV-DNA等生化指标,观察电话随访对疗效的影响。结果 L6(治疗12个月)蛋白尿得到控制的人数较L0(治疗前)显著增加,差异有统计学意义(P<0.05);白细胞计数均基本回到正常值,差异有统计学意义(P<0.05)。病人血清蛋白、胆固醇、三酰甘油指标恢复正常人数持续增加,差异有统计学意义(P<0.05)。观察组显效5例,有效21例,无效3例,总有效率89.66%;对照组显效3例,有效15例,无效9例,总有效率66.67%,明显低于观察组,差异有统计学意义(P<0.05)。结论科学护理,积极的心理辅导,以及及时督促复诊、观察病情发展等措施,能够有效改善乙肝相关性肾炎病人治疗中的的不适感,减少病人并发症的发生,提高生活质量。Objective To investigate the effects of regular follow-up and nursing intervention on the side effects and long-term therapeutic effects of hormone combined with cyclosporine in the treatment of hepatitis B associated nephritis.Methods 62 cases of hepatitis B related nephritis treated by hormone therapy in Harrison International Peace Hospital(Hengshui People’s Hospital)from March 2015 to March 2016 were randomly divided into observation group(31 cases)and control group(31 cases)by random digital table method.Control group received conventional hormone therapy,liver protection and basic nursing.On the basis of treatment in the control group,the observation group join diet nursing and psychological care.The effect of nursing was compared between the two groups.Telephone follow-up was performed at the same time to observe whether patients received regular follow-up visit,whether symptoms improved,whether complications occured,a total of 7 times.Blood routine examination liver and kidney function,24 h urine protein,albumin,lipids and quantitative biochemical indexes,HBV-DNA were compared during each patient’s return visit,and the effects of telephone follow-up on the efficacy were observed.Results The number of patients with proteinuria under control of L6 increased than that of L0,with statistically significant difference(P<0.05);Leukocyte count are back to normal,difference was statistically significant(P<0.05).Patients’blood albumin,cholesterol,triglyceride index,numbers continue to increase return to normal,difference was statistically significant(P<0.05).5 cases were excellence,21 cases were effective,3 cases were invalid,and the total efficiency was 89.66%.In the control group,3 cases were excellence,15 cases were effective,9 cases were invalid,total efficiency 66.67%,significantly lower than that in the observation group,and the difference was statistically significant(P<0.05).Conclusion Careful nursing,positive psychological counseling,and urging the timely followup and observing complications,developm

关 键 词：乙型肝炎/并发症 肾小球肾炎 甲泼尼龙 环孢素 随访研究 

分 类 号：R473.5[医药卫生—护理学]