精细化护理对肝硬化患者肝功能、焦虑状态的影响分析  

Analysis of the impact of refined nursing on liver function and anxiety status in patients with liver cirrhosis

作　　者：唐莉 赖雪梅[1] 刘慧[1] 陈飞燕 潘雪梅[1] TANG Li;LAI Xue-mei;LIU Hui(Department of Gastroenterology,Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510000,China)

机构地区：[1]中山大学附属第三医院消化内科,广州510000

出　　处：《医师在线》2024年第9期88-91,共4页Journal of Doctors Online

基　　金：中山大学附属第三医院2020年度护理科研基金资助项目(2020HL04);广东省护士协会2021年科研课题项目(gdshsxh2021a118)。

摘　　要：目的探讨精细化护理与缓解患者焦虑情绪、改善肝功能的关系。方法选取2023年6月~2023年12月中山大学附属第三医院收治的100例肝硬化患者为研究对象,采用随机数字表法分成观察组和对照组,各50例。对照组采用常规护理,观察组采用常规护理+精细化护理。比较治疗后两组肝功能、焦虑情况,并分析精细化护理对缓解焦虑症状和改善肝功能的效果。结果两组一般资料比较,差异无统计学意义(P>0.05)。治疗后,观察组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平和焦虑评分均显著低于对照组(P<0.05);观察组ALT、AST、焦虑评分三项指标的下降程度均显著大于对照组(P<0.05)。单因素分析显示,有焦虑和无焦虑患者性别、精细化护理比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,精细化护理是影响焦虑的独立因素(P<0.05)。采用广义估计方程分析精细化护理对各亚组人群焦虑的影响,结果显示,有12个亚组患者经过精细化护理显著减少了焦虑的发生(P<0.05)。中介效应分析显示,精细化护理在降低ALT水平时,14.3%由焦虑缓解的中介效应介导(P<0.05);在降低AST水平时,23.6%由焦虑缓解介导(P<0.05)。结论精细化护理有助于改善患者的焦虑症状,促进肝功能恢复,但仍需多中心、大样本的研究进一步证实。Objective To explore the relationship between refined nursing and alleviating patient anxiety and improving liver function.Methods A total of 100 patients with liver cirrhosis admitted to the Third Affiliated Hospital of Sun Yat-sen University from June 2023 to December 2023 were selected as the research subjects.They were divided into observation group and control group by random number table method,with 50 cases in each group.The control group received routine nursing,while the observation group received routine nursing and refined nursing.Compared the liver function and anxiety between the two groups after treatment,and analyzed the effect of refined nursing on relieving anxiety symptoms and improving liver function.Results There was no significant difference in general data between the two groups(P>0.05).After treatment,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and anxiety score of the observation group were significantly lower than those of the control group(P<0.05).The decrease of ALT,AST and anxiety score in the observation group was significantly higher than that in the control group(P<0.05).Univariate analysis showed that there were significant differences in gender and refined nursing between patients with anxiety and those without anxiety(P<0.05).Multivariate Logistic regression analysis showed that refined nursing was an independent factor affecting anxiety(P<0.05).The generalized estimation equation was used to analyze the effect of refined nursing on anxiety in each subgroup.The results showed that 12 subgroups of patient underwent refined mursing significantly reduced the occurrence of anxiety(P<0.05).The mediation effects analysis showed that 14.3%of the reduction of ALT levels was mediated by the mediating effect of anxiety relief(P<0.05),and the mediating effect accounted for 14.3%.When AST level was reduced,23.6%was mediated by anxiety relief(P<0.05).Conclusion Refined nursing is helpful to improve anxiety symptoms in patients and promote liver function recovery

关 键 词：肝硬化 精细化护理 肝功能 焦虑状态 

分 类 号：R473.5[医药卫生—护理学]