CAJ | 학술논문

目的：观察聚集解决护理模式对肝硬化食管胃底静脉曲张患者再次出血的预防作用。方法将120例肝硬化食管胃底静脉曲张患者按照奇偶数字法随机均分为对照组与观察组各60例，分别采用常规护理与聚集解决护理模式。比较两组预防再出血效果、护理干预前后焦虑自评量表(SAS)及抑郁自评量表(SDS)评分、游离肝静脉压(FHVP)、肝静脉楔压(WHVP)及肝静脉压力梯度(HVPG)的变化、静脉主干血流动力学及脾静脉血流动力学变化情况。结果观察组预防再出血效果显著优于对照组(P<0.05)；观察组护理干预后SAS及SDS评分显著低于干预前及对照组护理干预后(P<0.05)；观察组护理干预后WHVP及HVPG水平较护理干预前显著降低(P<0.05)；两组护理干预后血流动力学指标均较护理干预前显著降低(P<0.05)；两组护理干预前后脾静脉内径(Dpv)差异均无统计学意义(P>0.05)，但两组护理干预前后脾静脉流速(Vpv)及流量(Qpv)差异均具有统计学意义(P<0.05)。结论聚集解决护理模式能够更好地预防肝硬化食管胃底静脉曲张患者再出血，应在临床上加以推广应用。
목적：관찰취집해결호리모식대간경화식관위저정맥곡장환자재차출혈적예방작용。방법장120례간경화식관위저정맥곡장환자안조기우수자법수궤균분위대조조여관찰조각60례，분별채용상규호리여취집해결호리모식。비교량조예방재출혈효과、호리간예전후초필자평량표(SAS)급억욱자평량표(SDS)평분、유리간정맥압(FHVP)、간정맥설압(WHVP)급간정맥압력제도(HVPG)적변화、정맥주간혈류동역학급비정맥혈류동역학변화정황。결과관찰조예방재출혈효과현저우우대조조(P<0.05)；관찰조호리간예후SAS급SDS평분현저저우간예전급대조조호리간예후(P<0.05)；관찰조호리간예후WHVP급HVPG수평교호리간예전현저강저(P<0.05)；량조호리간예후혈류동역학지표균교호리간예전현저강저(P<0.05)；량조호리간예전후비정맥내경(Dpv)차이균무통계학의의(P>0.05)，단량조호리간예전후비정맥류속(Vpv)급류량(Qpv)차이균구유통계학의의(P<0.05)。결론취집해결호리모식능구경호지예방간경화식관위저정맥곡장환자재출혈，응재림상상가이추엄응용。
Objective To observe the preventive effect of solution-focused nursing on rebleeding in patients with esophageal and gastric variceal bleeding. Methods Totally 120 patients of esophageal and gastric variceal pa-tients were randomly divided into control group and observation group with 60 cases in each group, and they were giv-en routine nursing or solution-focused nursing, respectively. The effects of prevention of rebleeding, SAS, SDS scores, FHVP, WHVP, HVPG, main changes of hemodynamic changes of the splenic vein, hemodynamic changes before and after nursing intervention were compared. Results The effect of prevention of rebleeding in the observation group was significantly better than that in the control group (P<0.05). Both the SAS and SDS scores in the observation group were lower than those in the control group after nursing intervention (P<0.05). Compared to before nursing interven-tion, WHVP and HVPG levels in the observation group were significantly decreased after nursing intervention (P<0.05). There were no statistical differences in splenic vein (Dpv) before and after the intervention (P>0.05), but there were statistical differences in splenic venous flow (Vpv) and flow volume (Qpv) in the two groups before and after nursing intervention (P<0.05). Conclusion The solution-focused nursing can better prevent esophageal and gastric variceal rebleeding, and it should be widely applied in clinical practice.