优质护理服务模式下的护理干预对肝硬化上消化道出血患者的影响

徐芳 李珍珠 刘光胜 刘斌

【摘要】 目的：探討优质护理服务模式下的护理干预对肝硬化上消化道出血患者的影响。方法：选取2017年1月-2020年1月于九江市柴桑区人民医院住院的肝硬化上消化道出血患者74例。按照随机数字表法分为对照组和病例组，每组37例。对照组给予常规护理干预，病例组给予优质护理服务模式下的护理干预。比较两组患者的干预效果、临床症状和并发症、生活质量评分、焦虑评分和满意度。结果：病例组治疗总有效率为97.30%高于对照组的81.08%，差异有统计学意义（P<0.05）。病例组出血量少于对照组，出血时间短于对照组，再出血率和并发症发生率均低于对照组，差异均有统计学意义（P<0.05）。病例组的日常生活、运动、健康、总体精神、近期支持、生活质量总指数评分均高于对照组，差异均有统计学意义（P<0.05）。干预后，两组患者SAS评分、HAMA评分均较干预前下降（P<0.05）。干预后，病例组SAS评分、HAMA评分均低于对照组，差异均有统计学意义（P<0.05）。病例组的满意度为100%高于对照组的86.49%，差异有统计学意义（P<0.05）。结论：优质护理服务模式下的护理干预可以显著改善肝硬化上消化道出血患者的临床症状，减少并发症的发生，改善患者焦虑状态，提高生活质量和对护理的满意度，值得临床大力推广。

【关键词】 肝硬化上消化道出血 优质护理 护理干预

Effect of Nursing Intervention under the Mode of High-quality Nursing Service on Patients with Hepatic Cirrhosis Upper Gastrointestinal Bleeding/XU Fang， LI Zhenzhu， LIU Guangsheng， LIU Bin. //Medical Innovation of China， 2021， 18（10）： 0-084

[Abstract] Objective： To explore the effect of nursing intervention under the mode of high-quality nursing service on patients with hepatic cirrhosis upper gastrointestinal bleeding. Method： A total of 74 patients with cirrhosis and upper gastrointestinal bleeding who were admitted to the Peoples Hospital of Chaisang District， Jiujiang City from January 2017 to January 2020 were selected. According to random number table method， they were divided into control group and case group， 37 cases in each group. The control group was given routine nursing intervention， and the case group was given nursing intervention under the mode of high-quality nursing service. Intervention effect， clinical symptoms and complications， quality of life score， anxiety score and satisfaction were compared between the two groups. Result： The total effective rate of the case group was 97.30% higher than 81.08% of the control group， the difference was statistically significant （P<0.05）. The amount of bleeding， the bleeding time， the rebleeding rate and the incidence of complications in the case group were lower than those in the control group， the differences were statistically significant （P<0.05）. The scores of daily life， exercise， health， general spirit， recent support and total quality of life index in the case group were all higher than those in the control group， the differences were statistically significant （P<0.05）. After intervention， SAS score and HAMA score of patients in two groups decreased compared with before intervention （P<0.05）. After intervention， SAS score and HAMA score in case group were lower than those in control group， the differences were statistically significant （P<0.05）. The satisfaction of the case group was 100% higher than 86.49% of the control group， the difference was statistically significant （P<0.05）. Conclusion： Nursing intervention under the mode of high-quality nursing service can significantly improve the clinical symptoms of patients with upper gastrointestinal bleeding from cirrhosis， reduce the incidence of complications， improve the anxiety of patients， improve the quality of life and satisfaction with nursing， which is worthy of clinical promotion.

[Key words] Hepatic cirrhosis upper gastrointestinal bleeding High-quality nursing Nursing intervention

First-authors address： Peoples Hospital of Chaisang District， Jiujiang 332100， China

doi：10.3969/j.issn.1674-4985.2021.10.019

病毒性肝炎是我国最常见的肝硬化类型，其中尤其以乙型肝炎病毒（hepatitis B virus， HBV）感染为主，据统计，全球有超过20亿人口感染或曾经感染过HBV。肝硬化患者易引起上消化道出血、感染等并发症，且远期预后差[1]。其中上消化道出血是肝硬化患者最常见的并发症，起病急，病情进展快。其中食管胃底静脉曲张破裂引起的大量呕血和黑便，容易引起失血性休克，严重者可引起肝性脑病甚至导致患者死亡，严重降低患者的生活質量[2]。有研究表明，优质护理模式下的护理干预可以改善患者的临床疗效[3]。本研究对肝硬化上消化道出血患者采取优质护理服务模式下的护理干预进行研究，为探讨新型模式下的护理干预提供参考，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年1月-2020年1月于九江市柴桑区人民医院住院的肝硬化上消化道出血患者74例。……