傅樟瑜 王艳 应乐迪 王威

[摘要] 目的 探讨健康教育对激素敏感型肾病综合征患儿临床疗效和生活质量的影响。 方法 选择2015年1月～2016年12月在温州医科大学附属第二医院诊治的激素敏感型肾病综合征患儿，分为干预组60例、对照组58例，均接受糖皮質激素治疗，干预组对患儿及家长进行持续健康教育，内容包括疾病知识宣教、心理辅导、生活指导。采用QLICD量表和Barthel指数评价患儿的生活质量，并对比两组干预后临床疗效、治疗依从性及并发症。结果 6个月后，干预组临床疗效好于对照组（P<0.05）。干预组躯体功能、社会功能、心理状态、特异模块、总分及Barthel指数评分均明显高于对照组（P<0.05）。干预组治疗依从性显著高于对照组（P<0.05），干预组感染、静脉血栓、急性肾功能衰竭、营养不良的发生率均显著低于对照组（P<0.05）。 结论 健康教育有助于提高激素敏感型肾病综合征患儿治疗依从性，从而提高临床疗效和生活质量，减少并发症及不良预后。

[关键词] 儿童；肾病综合征；健康教育；生活质量

[中图分类号] R473.72 [文献标识码] B [文章编号] 1673-9701（2018）07-0161-04

[Abstract] Objective To investigate the effect of health education on clinical efficacy and quality of life in children with steroid-sensitive nephrotic syndrome. Methods The children with steroid-sensitive nephrotic syndrome who were diagnosed and treated at the Second Affiliated Hospital of Wenzhou Medical University from January 2015 to December 2016 were divided into intervention group （n=60） and control group （n=58）， both receiving glucocorticoid therapy. The children and their parents in the intervention group were treated with continuous health education， which included disease knowledge education， psychological counseling and life guidance. The QLICD scale and Barthel index were used to evaluate the quality of life in children. The clinical efficacy， treatment compliance and complications were compared between the two groups. Results After 6 months， the clinical efficacy of the intervention group was better than that of the control group（P<0.05）. The body function， social function， psychological status， specific module， total score and Barthel index in the intervention group were significantly higher than those in the control group（P<0.05）. The treatment compliance in the intervention group was significantly higher than that in the control group（P<0.05）. The incidences of infection， venous thrombosis， acute renal failure and malnutrition in the intervention group were significantly lower than those in the control group（P<0.05）. Conclusion Health education helps to improve the treatment compliance of children with steroid-sensitive nephrotic syndrome， thereby improving clinical efficacy and quality of life， and reducing complications and poor prognosis.

[Key words] Children； Nephrotic syndrome； Health education； Quality of life

肾病综合征（nephrotic syndrome，NS）是临床以大量蛋白尿、严重低蛋白血症、高度水肿、高脂血症为表现的一组综合征，在3～5岁儿童中高发，发病原因与NPHSl、NPHS2和WT1基因突变有关[1]。本病具有病程迁延难愈、需要长期住院治疗、并发症多等特点，严重影响患儿的生活质量[2]。同时，本病的治疗周期长，治疗药物繁多，且以糖皮质激素为主药物不良反应大，患儿的依从性与临床疗效密切相关[3]。本文观察健康教育干预对改善激素敏感型肾病综合征患儿临床疗效、生活质量、依从性的作用，现报道如下。

1资料与方法

1.1一般资料

选择2015年1月～2016年12月温州医科大学附属第二医院诊治的激素敏感型肾病综合征患儿；年龄≥5岁，≤14岁；男女不限；所有临床资料保持完整；患儿家属对健康教育及相关研究方式完全知情同意。排除合并其他系统严重功能不全或障碍者、合并肿瘤、精神疾病者。……