王明哲

【摘要】 目的：探讨优质护理对乙型肝炎后肝硬化伴上消化道出血治疗的辅助作用。方法：选取2016年5月-2017年5月本院收治的乙型肝炎后肝硬化伴上消化道出血患者86例。按照随机数字表法将其分为对照组和研究组，各43例。两组均接受针对性治疗，然后在此基础上对照组应用常规护理干预，研究组应用优质护理干预。比较两组止血时间、出血量以及住院时间、心理状态（SAS、SDS）干预效果及满意度。结果：研究组出血量、出血时间均少于对照组（P<0.05），但住院时间长于对照组（P<0.05）;研究组总满意率为93.0%，高于对照组的74.4%（P<0.05）;干预后，研究组SAS、SDS评分均低于对照组（P<0.05）;研究组总有效率为93.0%，高于对照组的76.7%（P<0.05）。结论：在乙型肝炎后肝硬化伴上消化道出血过程当中，采用优质护理进行辅助治疗可以有效提高干预效果，促进患者康复，提高患者满意度，临床上应当进一步推广应用。

【关键词】 优质护理; 乙型肝炎; 肝硬化; 上消化道出血

【Abstract】 Objective：To explore the auxiliary effect of high quality nursing on the treatment of cirrhosis after hepatitis b with upper gastrointestinal bleeding.Method：A total of 86 patients with cirrhosis after hepatitis b with upper gastrointestinal bleeding from May 2016 to May 2017 in our hospital were selected.According to the random number table method，they were divided into control group and study group，43 cases in each group.Both groups received targeted treatment，and on this basis，the control group was given routine nursing intervention，while the study group was given high quality nursing intervention.The time of hemostasis，the amount of bleeding，the length of hospitalization，the effect of psychological state（SAS，SDS）intervention and satisfaction between two groups were compared.Result：The amount of bleeding and the time of bleeding in study group were less than those of control group（P<0.05），but the length of hospitalization was longer than that of control group（P<0.05）.The total satisfaction rate of study group was 93.0%，which was higher than 74.4% of control group（P<0.05）.After intervention，the SAS and SDS scores in study group were lower than those of control group（P<0.05）.The total effective rate was 93.0% in study group，which was higher than 76.7% of control group（P<0.05）.Conclusion：In the process of cirrhosis after hepatitis b with upper gastrointestinal bleeding，the use of high quality nursing can effectively improve the intervention effect，promote the rehabilitation of patients，improve patient satisfaction，clinical application should be further promoted.

【Key words】 Quality nursing; Hepatitis b; Cirrhosis; Upper gastrointestinal bleeding

First-authors address：Jiamusi Infectious Disease Hospital，Jiamusi 154001，China

doi：10.3969/j.issn.1674-4985.2019.08.022

肝臟炎症泛指肝炎，属于肝细胞损伤疾病，一般情况是由病毒、细菌等因素导致，使患者肝功能出现障碍，进而引发患者出现全身性症状，影响患者的生命安全[1]。由甲、乙、丙型病毒导致的病毒性肝炎是目前临床比较常见的肝炎类型，引发患者疾病发生的病毒种类不同，患者的临床症状表现也会存在差异[2]。由乙型病毒导致的乙肝肝硬化是指受病毒影响，肝脏结构发生破坏，在发病初期，受肝脏代偿功能影响，患者并没有明显的临床症状[3]。随疾病发展，受肝脏功能障碍影响，脾脏会表现出功能亢进，消化道出血是肝硬化晚期最常见的并发症，以恶心、呕吐以及大便异常为主要临床症状，具有较高的致死率，对患者生命安全造成严重威胁[4]。曾有研究证实，对于乙型肝炎后肝硬化伴上消化道出血患者进行积极有效的治疗并配合护理干预，可以及时改善患者出血状况，改善患者生活质量[5]。……