摘要
目的 探讨肝硬化食管胃静脉曲张破裂出血(EVB)患者经颈静脉肝内门体静脉支架分流术(TIPS)后发生肝性脑病的危险因素分析及循证护理措施。方法 选取2019年9月至2022年9月在该院接受治疗的肝硬化EVB患者106例作为研究对象,所选患者均在入院72 h内行TIPS治疗,按照随机数表法将其分为对照组(n=53)和观察组(n=53)两组,对照组患者给予常规护理措施进行干预,观察组患者给予循证护理措施进行干预。肝硬化EVB患者TIPS术后发生肝性脑病的危险因素采用单因素、多因素Logistic进行回归分析,并对护理后两组患者肝性脑病的发生情况进行评估分析。结果 单因素分析表明,CT、MELD评分及HVPG与TIPS术后发生肝性脑病的相关性显著(P <0.05);多因素Logistic回归分析表明,肝硬化EVB患者TIPS术后发生肝性脑病的危险因素与MELD评分、HVPG有着显著的相关性(P <0.05);TIPS术护理后观察组肝性脑病的总发生率为3.77%,明显低于对照组的18.87%(P <0.05)。结论 MELD评分、HVPG是肝硬化EVB患者TIPS术后肝性脑病发生风险的独立危险因素,经循证护理干预后发生肝性脑病的风险有效降低。
Objective To investigate the risk factors for hepatic encephalopathy after transjugular intrahepatic portosystemic stenting shunt(TIPS)in patients with liver cirrhosis esophageal variceal bleeding(EVB)and evidence-based nursing measures.Methods A total of 106 EVB patients with liver cirrhosis who received treatment in the hospital from March 2020 to March 2021 were selected as study subjects,and all the selected patients were treated with TIPS within 72 hours of admission,and they were divided into two groups,control group(n=53)and observation group(n=53)according to the random number table method,the control group patients were given routine nursing measures for intervention,and the observation group patients were given evidence-based nursing measures for intervention.The risk factors for hepatic encephalopathy after TIPS in EVB patients with cirrhosis were regression analysis by univariate and multivariate logistic,and the occurrence of hepatic encephalopathy in the two groups after nursing was evaluated and analyzed.Results Univariate analysis showed that CT,MELD score and HVPG were significantly correlated with hepatic encephalopathy after TIPS(P<0.05),and multivariate logistic regression analysis showed that the risk factors for hepatic encephalopathy after TIPS in EVB patients with cirrhosis had a significant correlation with MELD score and HVPG(P<0.05),and the total incidence of hepatic encephalopathy in the observation group after TIPS was 3.77%,which was significantly lower than that of the control group of 18.87%(P<0.05).Conclusion MELD score and HVPG are independent risk factors for the risk of hepatic encephalopathy after TIPS in EVB patients with cirrhosis,and the risk of hepatic encephalopathy is effectively reduced after evidence-based nursing intervention.
作者
林熔
郭霞
LIN Rong;GUO Xia(Department of Intervention,Mengchao Hepatobiliary Hospital,Fujian Medical University,Fuzhou 350025,China)
出处
《中国医药指南》
2023年第22期168-170,共3页
Guide of China Medicine
关键词
食管胃静脉曲张破裂出血
肝性脑病
危险因素
循证护理
Esophageal and gastric variceal bleeding
Hepatic encephalopathy
Risk factors
Evidence-based care
