基于冰山理论的一体化全程管理对人工肝血浆置换治疗肝衰竭病人的护理效果  

Application of integrated full-process management based on iceberg theory in the treatment of patients with liver failure by artifi cial liver plasma exchange

作　　者：陈惠华[1] 黄清珠[1] 蔡榕华[1] 沈延琴 陈瑾瑜 CHEN Huihua;HUANG Qingzhu;CAI Ronghua;SHEN Yanqin;CHEN Jinyu(Southeast Hospital Affiliated to Xiamen University/No.909 Hospital,Zhangzhou 363000,China)

机构地区：[1]厦门大学附属东南医院/第九〇九医院感染科,福建省漳州市363000

出　　处：《护理实践与研究》2024年第10期1568-1573,共6页Nursing Practice and Research

摘　　要：目的探讨基于冰山理论的一体化全程管理在人工肝血浆置换(plasma exchange,PE)治疗肝衰竭病人中的应用效果。方法选取2018年10月—2022年12月于医院进行人工肝PE治疗的106例肝衰竭病人为研究对象,按照组间基线资料均衡可比的原则将其分为对照组与观察组,各53例。对照组实施常规一体化全程管理,观察组实施基于冰山理论的一体化全程管理,两组均干预至病人出院。采用症状自评量表(SCL-90)、医院自制遵医行为评价量表、工具性日常生活活动能力(IADL)量表分别评估两组病人的心理状况、遵医行为和生活质量;观察比较两组病人不良事件发生率。结果干预后,观察组病人SCL-90评分低于对照组,差异具有统计学意义(P<0.05);干预后,观察组病人遵医行为评价量表中治疗、用药、饮食、运动评分高于对照组,差异具有统计学意义(P<0.05);干预后,观察组病人IADL评分高于对照组,差异具有统计学意义(P<0.05);两组病人住院期间不良事件发生率比较差异无统计学意义(P>0.05)。结论基于冰山理论的一体化全程管理可改善人工肝PE治疗肝衰竭病人心理状态,提高其遵医行为,改善其生活质量。Objective To explore the application effect of integrated full process management based on iceberg theory in the treatment of patients with liver failure by artifi cial liver plasma exchange(PE).Methods There were106 patients with liver failure who recieved artifi cial liver PE treatment in hospitals from October 2018 to December 2022 were selected as the study subjects.According to the principle of balanced and comparable baseline data between groups,they were divided into the control group and the observation group,with 53 cases in each group.The control group implemented routine integrated full-cycle management,the observation group implemented integrated full-cycle management based on iceberg theory.Both groups intervened until the patient was discharged.The Symptom Checklist 90(SCL-90),hospital self-designed compliance behavior evaluation scale,and Instrumental Activity of Daily Living(IADL)scale were used to evaluate the psychological status,compliance behavior,and quality of life of the patients in the two groups.The incidence of adverse events was observed and compared between the two groups.Results After the intervention,the SCL-90 score of patients in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After the intervention,the treatment,medication,diet,and exercise scores of patients in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).After the intervention,the IADL score of patients in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups during hospitalization(P>0.05).Conclusion Integrated full-process management based on iceberg theory could improve the psychological status of patients with liver failure treated with artifi cial liver PE,improve their compliance behavior,and improve thei

关 键 词：肝衰竭 人工肝血浆置换 冰山理论 一体化全程管理 心理状态 

分 类 号：R473[医药卫生—护理学]