整体护理对肝硬化门脉高压并消化道出血行TIPSS患者生存质量的影响  

Effect of holistic Nursing on Quality of Life in cirrhotic Patients with Portal Hypertension and TIPSS by gastrointestinal Bleeding

作　　者：薛珍琴 郭林红 XUE Zhenqin;GUO Linhong(Interventional Radiology Department,the 900th Hospital of the Joint Logistics Support Force,Fuzhou Fujian 350025,China)

机构地区：[1]联勤保障部队第九〇〇医院放射诊断科介入病房,福建福州350025

出　　处：《临床研究》2020年第11期135-137,共3页Clinical Research

摘　　要：目的探讨整体护理对肝硬化门脉高压并消化道出血(EGVB)患者行经颈静脉肝内门静脉内支架分流术(TIPSS)生存质量的影响。方法采用前瞻性队列研究方法,将2015年12月—2018年12月就诊于联勤保障部队第九〇〇医院的72例肝硬化门脉高压并EGVB患者随机分为干预组和对照组。干预组采用整体护理模式,对照组采用常规护理模式。所有患者均接受TIPSS,采用抑郁自评量表(SDS)、焦虑自评量表(SAS)和症状自评SCL-90量表分别对患者的心理状态进行评估,并采用SF-36简明健康调查量表对手术前后的生存质量进行评价,随访时间点为手术前1天和手术后1周。比较两组患者心理状态和生存质量之间的差别。结果干预组术中出血量及住院天数均低于对照组,差异具有统计学意义(P<0.05);干预组术后SAS评分和SDS评分均低于对照组,差异具有统计学意义(P<0.05);干预组躯体化症状、强迫、抑郁、焦虑、敌对、恐怖和偏执等心理状态评分显著低于对照组,差异具有统计学意义(P<0.05);干预组术后生存质量评分均显著高于对照组,组间差异均具有统计学意义(P<0.05)。结论肝硬化门脉高压并消化道出血(EGVB)行TIPSS患者均存在不同程度的心理健康问题,整体护理可有效提高临床疗效,改善心理状态,提升生存质量。Objective To explore the effect of holistic nursing care on the quality of life of cirrhotic portal hypertension patients undergoing transjugular intrahepatic portosystemic stent shunt(TIPSS).Methods A prospective cohort study was conducted to randomly divide 72 patients with cirrhosis portal hypertension and EGVB into intervention group and control group in December 2015 and December 2018 respectively.The intervention group was treated with holistic nursing model,while the control group was treated with routine nursing model.All patients received TIPSS and were evaluated by selfrating depression scale(SDS),self-rating anxiety scale(SAS)and symptom checklist-90(SCL-90),the quality of life before and after operation was evaluated by SF-36 health survey.The follow-up time was 1 day before operation and 1 week after operation.The differences of mental status and quality of life between the two groups were compared.Results The blood loss and hospitalization days in intervention group were significantly lower than those in control group(P<0.05),and the scores of SAS and SDS in intervention group were significantly lower than those in control group(P<0.05).The scores of somatization symptoms,compulsion,depression,anxiety,hostility,terror and paranoia in intervention group were significantly lower than those in control group(P<0.05).The postoperative quality of life scores in the intervention group were significantly higher than those in the control group(P<0.05).Conclusion The patients with liver cirrhosis,portal hypertension and TIPSS have different degree of mental health problems.Holistic nursing can effectively improve the clinical efficacy,improve the mental state and improve the quality of life.

关 键 词：肝硬化 整体护理 门脉高压 消化道出血 生存质量 

分 类 号：R473.6[医药卫生—护理学]