CAJ | 학술논문

目的：探讨群组看病管理模式在社区乙型肝炎中的应用效果。方法将60例HBeAg阴性出院的乙肝患者按抛硬币分组法随机分为研究组（30例）和对照组（30例），对照组按自我管理模式，不给予任何形式的社区医护干预。研究组实施群组看病管理模式，干预时间为1年。于干预前和干预3，6，9，12个月，采用慢性肝病症状评分标准、肝功能指标和慢性肝病问卷（ CLDQ）评价两组康复效果和生活质量。结果干预前，研究组慢性肝病症状评分和CLDQ总评分分别为（4．62±2．45），（105．79±13．54）分，对照组分别为（5．74±2．54），（105．61±13．48）分，两组比较差异均无统计学意义（t值分别为1．74，0．14；P＞0．05）；两组肝功能各项指标评分比较差异亦均无统计学意义（P＞0．05）；干预后6，9，12个月，研究组慢性肝病症状总评分分别为（6．68±3．21），（7．70±3．33），（7．19±3．12）分，对照组评分分别为（9．05±3．52），（10．10±3．27），（11．15±3．22）分，两组比较差异具有统计学意义（t值分别为2．72，2．82，4．84；P＜0．05）；研究组CLDQ总评分分别为（146．62±15．62），（162．30±16．87），（176．76±18．12）分，对照组分别为（118．91±15．51），（124．52±16．33），（131．25±17．42）分，两组比较差异具有统计学意义（t值分别为6．89，9．05，9．92；P＜0．01）；两组患者不同时段慢性肝病症状各项评分及CLDQ问卷各维度评分比较差异均有统计学意义（ P＜0．05）。研究组肝功能各项指标及HBV-DNA评分均明显优于对照组，差异具有统计学意义（P＜0．05）。结论对社区乙肝患者实施群组看病管理能够较好地维持患者身心健康，提高其生活质量，值得临床推广应用。
목적：탐토군조간병관리모식재사구을형간염중적응용효과。방법장60례HBeAg음성출원적을간환자안포경폐분조법수궤분위연구조（30례）화대조조（30례），대조조안자아관리모식，불급여임하형식적사구의호간예。연구조실시군조간병관리모식，간예시간위1년。우간예전화간예3，6，9，12개월，채용만성간병증상평분표준、간공능지표화만성간병문권（ CLDQ）평개량조강복효과화생활질량。결과간예전，연구조만성간병증상평분화CLDQ총평분분별위（4．62±2．45），（105．79±13．54）분，대조조분별위（5．74±2．54），（105．61±13．48）분，량조비교차이균무통계학의의（t치분별위1．74，0．14；P＞0．05）；량조간공능각항지표평분비교차이역균무통계학의의（P＞0．05）；간예후6，9，12개월，연구조만성간병증상총평분분별위（6．68±3．21），（7．70±3．33），（7．19±3．12）분，대조조평분분별위（9．05±3．52），（10．10±3．27），（11．15±3．22）분，량조비교차이구유통계학의의（t치분별위2．72，2．82，4．84；P＜0．05）；연구조CLDQ총평분분별위（146．62±15．62），（162．30±16．87），（176．76±18．12）분，대조조분별위（118．91±15．51），（124．52±16．33），（131．25±17．42）분，량조비교차이구유통계학의의（t치분별위6．89，9．05，9．92；P＜0．01）；량조환자불동시단만성간병증상각항평분급CLDQ문권각유도평분비교차이균유통계학의의（ P＜0．05）。연구조간공능각항지표급HBV-DNA평분균명현우우대조조，차이구유통계학의의（P＜0．05）。결론대사구을간환자실시군조간병관리능구교호지유지환자신심건강，제고기생활질량，치득림상추엄응용。
Objective To discuss the effect of group medical visits on community patients with hepatitis B.Methods 60 patients with hepatitis B discharged from hospital whose HBeAg was feminine were randomly divided into the study group and the control group , each with 30 cases.The control group adopted self-management mode without any community nursing intervention , while the study group adopted the group medical visits for one year .The standard of chronic liver disease symptom score , liver function indicator and CLDQ were used to evaluate rehabilitation effect and quality of life in two groups before intervention , 3 months, 6 months, 9 months and one year after intervention .Results Before intervention , the score of chronic liver disease symptom and CLDQ was respectively (4.62 ±2.45),(105.79 ±13.54)in the study group and (5.74 ±2.54), (105.61 ±13.48 ) in the control group, with no statistically significant difference ( t =1.74, 0.14, respectively;P>0.05).There was also no statistically significant difference of liver function indicators between two groups (P>0.05).6 months, 9 months and 1 year after intervention, the score of chronic liver disease symptom was (6.68 ±3.21),(7.70 ±3.33),(7.19 ±3.12)in the study group, (9.05 ±3.52),(10.10 ± 3.27),(11.15 ±3.22) in the control group, and the differences were statistically significant (t=2.72,2.82, 4.84, respectively;P<0.05).The score of CLQD was (146.62 ±15.62),(162.30 ±16.87),(176.76 ± 18.12)in the study group, (118.91 ±15.51),(124.52 ±16.33),(131.25 ±17.42)in the control group, the differences were statistically significant (t =6.89,9.05,9.92, respectively; P <0.01).There was also statistically significant difference of scores of all dimensions of chronic liver disease symptom and CLDQ between two groups (P<0.05).All liver function indicators and score of HBV-DNA were better in the study group than in the control group, with statistically significant difference (P<0.05).Conclusions Group medical visits for community patients with hepatitis B can help keep their physical and psychological health and improve their quality of life, which is worthy clinical promotion .