孙奕纯

【摘要】 目的 探讨结肠水疗防治乙肝肝硬化失代偿期患者并发肝性脑病的护理效果。方法 100例既往有乙肝肝硬化失代偿期伴或不伴有肝性脑病病史的患者， 依据是否予结肠水疗分为对照组和观察组， 各50例。对照组给予抗病毒、护肝、饮食指导、心理支持等西医常规治疗， 观察组在对照组治疗护理基础上使用JS-308A结肠透析机进行结肠水疗。观察两组患者治疗3个月后患者精神状态、扑翼样震颤、静脉血氨浓度的情况。结果 观察组精神状态的改变症状6例（12%）少于对照组的18例（36%）， 观察组患者出现不同程度的扑翼样震颤6例（12%）低与对照组的18例（36%）， 观察组的血氨异常升高发生率为7例（14%）低于对照组的20例（40%）；差异均有统计学意义（P<0.05）。结论 结肠水疗可以有效的预防乙肝肝硬化失代偿期患者肝性脑病的发生， 提高患者预后水平， 值得临床推广应用。

【关键词】 结肠水疗；乙肝肝硬化失代偿期；肝性脑病；护理观察

DOI：10.14163/j.cnki.11-5547/r.2016.33.080

Nursing observation of colon hydropathy in prevention and treatment of decompensated hepatitis B cirrhosis complicated with hepatic encephalopathy SUN Yi-chun. Guangdong Zhongshan City Hospital of Traditional Chinese Medicine， Zhongshan 528400， China

【Abstract】 Objective To investigate nursing effect by colon hydropathy in prevention and treatment of decompensated hepatitis B cirrhosis complicated with hepatic encephalopathy. Methods A total of 100 patients of decompensated hepatitis B cirrhosis with or without complicated hepatic encephalopathy were divided by receiving colon hydropathy or not into control group and observation group， with 50 cases in each group. The control group received conventional Western therapy of antivirus， liver protection， diet guidance and psychological support. The observation group also received additional JS-308A colon dialysis machine for colon hydropathy. Observation was made on mental state， asterixis and venous blood ammonia concentration after 3 months of treatment in both groups. Results The observation group had 6 cases with changed mental state （12%）， which was less than 18 cases （36%） in the control group. The observation group also had less case with different asterixis degree as 6 cases （12%） than 18 cases （36%） in the control group. The observation group had lower incidence of abnormity elevatory blood ammonia in 7 cases （14%） than in 20 cases （40%） of the control group. Their differences all had statistical significance （P<0.05）. Conclusion Colon hydropathy can effectively prevention hepatic encephalopathy in decompensated hepatitis B cirrhosis patients. This method can improve prognosis level in patients， and it is worth clinical promotion and application.

【Key words】 Colon hydropathy； Decompensated hepatitis B cirrhosis； Hepatic encephalopathy； Nursing observation

肝性脑病是肝功能衰竭患者严重并发症和死亡的重要原因。引起肝性脑病的原发病有很多种， 其中以肝硬化为主， 特别是肝炎后肝硬化是引起肝性脑病最常见的原因[1]。国外报道肝性脑病的发病率为10%～84%[2]。国内报道肝硬化患者轻型肝性脑病发病率为50.9%[3]， 肝性脑病的发病率随着肝功能的变差而增高， 肝功能Child-Pugh A、B、C级发病率分别是39.9%、55.2%和71.8%[4]。本研究對结肠水疗防治乙肝肝硬化失代偿期患者并发肝性脑病的临床护理情况进行分析， 现将结果报告如下。

1 资料与方法

1. 1 一般资料 选取本院2015年1月～2016年1月包括门诊、住院部诊断为乙肝肝硬化失代偿期的患者， 既往有或无肝性脑病病史的患者100例临床资料。……