对症护理及术前风险评估对于TIPS安全性及预后恢复的价值研究  

Study on the value of symptomatic nursing and preoperative risk assessment for TIPS safety and prognostic recovery

作　　者：冯保红 李春霞[1] 岳建华 Feng Baohong;Li Chunxia;Yue Jianhua(Intervention department,first affiliated hospital of Zhengzhou University,Zhengzhou,Henan,450052,China.)

机构地区：[1]郑州大学第一附属医院介入科,河南郑州450052

出　　处：《齐齐哈尔医学院学报》2022年第6期593-597,共5页Journal of Qiqihar Medical University

摘　　要：目的探讨对症护理及术前风险评估对于TIPS安全性及预后恢复的价值。方法选择2018年8月—2020年8月本院收治的102例进行经颈静脉肝内门腔静脉分流术(TIPS)的患者作为研究对象,随机将其分为观察组和对照组两组,每组各51例。观察组采用对症护理以及术前风险评估,对照组采用常规护理模式。对比两组患者的肝功能、遵医嘱行为、复发情况与并发症发生情况以及生活质量。结果两组患者术后出院前Child-Pugh评分、血氨水平比较无明显差异(P>0.05);出院后1个月和3个月两组患者Child-Pugh评分降低、血氨水平,出院后3个月明显高于出院后1个月和术后出院前,且观察组低于对照组(P<0.05)。两组患者出院后1个月医依从性行为相关评分比较无明显差异(P>0.05);出院后3个月两组患者医依从性行为相关评分明显降低,且观察组低于对照组(P<0.05)。观察组术后复发率,阴囊血肿、尿潴留、阴囊气肿、暂时性神经感觉异常等并发症发生率均低于对照组(P<0.05)。术后出院时两组患者精神健康、情感职能、活力、生理职能、生理功能、总体健康评分比较无明显差异(P>0.05);出院后3个月两组患者精神健康、情感职能、活力、生理职能、生理功能、总体健康评分均升高,且观察组高于对照组(P<0.05)。结论对症护理及术前风险评估能够提升颈静脉肝内门腔静脉分流术患者的肝功能,提升患者出院后遵医嘱依从性,降低并发症与复发情况,提升患者生活质量,值得临床应用推广。Objective To explore the value of symptomatic care and preoperative risk assessment for the safety and prognostic recovery of TIPS.Methods 102 patients underwent transjugular intrahepatic portal vena cava shunt(TIPS)in our hospital from August 2018 to August 2020 were enrolled in the study,and they were randomly divided into observation group(n=51)and control group(n=51).The observation group was treated with symptomatic nursing and preoperative risk assessment,and the control group was treated with routine nursing mode.The liver function,behavior of follow doctor's advice,recurrence,complications and quality of life of the two groups were compared.Results There was no significant difference in child-Pugh score and blood ammonia levels between the two groups during the time period postoperative to before discharge(P>0.05).At 1 month and 3 months after discharge,the child-Pugh score of the two groups decreased,and the child-Pugh score at 3 months after discharge was significantly higher than that at 1 month after discharge and before discharge,and the score of the observation group was significantly lower than that of the control group(P<0.05).There was no significant difference in the scores of compliance behavior between the two groups one month after discharge(P>0.05).However,the scores of compliance behavior in the two groups decreased significantly three months after discharge,and the scores in the observation group were lower than those in the control group(P<0.05).The postoperative recurrence rate,scrotal hematoma,residual urine,scrotal emphysema and temporary nerve paresthesia in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the scores of mental health,emotional function,vitality,physiological function,physiological function and overall health between the two groups at discharge(P>0.05).The scores of mental health,emotional function,vitality,physiological function,physiological function and overall health of the two groups increased at 3 mon

关 键 词：对症护理 术前风险评估 TIPS 肝功能 生活质量 

分 类 号：R473.6[医药卫生—护理学]