CAJ | 학술논문

目的：通过个体化护理干预方法,提高丙型肝炎患者抗病毒治疗的依从性,医患共同努力以获得更加长久和持续的病毒学应答。方法2011年9月—2012年5月将78例参加聚乙二醇化重组集成干扰素变异体( PEG-IFN-SA )临床试验的慢性丙型肝炎受试者随机分为观察组和对照组,每组39例。对照组按研究方案要求正常回访。观察组在给药后4,8,12,24周给予90项症状清单(SCL-90)问卷测试,了解每个患者在治疗过程中出现的社会、家庭、身心健康等方面的问题,针对性地进行护理干预。比较两组患者抗病毒治疗的完成情况和不良反应发生情况。结果观察组按照方案规定完成抗病毒治疗的人数为29例(74.36%),对照组为19例(48.7%),观察组完成率高于对照组,差异有统计学意义(χ2=5.41,P<0.05)。观察组平均完成周数为(32±8)周,对照组平均完成周数为(26±7)周,观察组平均完成周数长于对照组,差异有统计学意义(t=3.52,P<0.05)。观察组流感样症状和易激惹等情绪改变发生率均低于对照组,差异有统计学意义(P<0.05)；甲状腺功能异常、眼痛、胃肠道反应、肌肉关节痛等其他不良反应发生率与对照组比较差异无统计学意义(P>0.05)。研究中共有5例患者有明显焦虑、抑郁症状,均发生在对照组。结论个性化护理干预有效解决了患者对干扰素抗HCV不良反应知识缺乏的问题,有效缓解丙肝患者由于不良反应所带来的负面情绪,减轻了精神异常发生的程度,增加了抗病毒治疗的信心,提高了丙肝患者的依从性和持续应答率。
목적：통과개체화호리간예방법,제고병형간염환자항병독치료적의종성,의환공동노력이획득경가장구화지속적병독학응답。방법2011년9월—2012년5월장78례삼가취을이순화중조집성간우소변이체( PEG-IFN-SA )림상시험적만성병형간염수시자수궤분위관찰조화대조조,매조39례。대조조안연구방안요구정상회방。관찰조재급약후4,8,12,24주급여90항증상청단(SCL-90)문권측시,료해매개환자재치료과정중출현적사회、가정、신심건강등방면적문제,침대성지진행호리간예。비교량조환자항병독치료적완성정황화불량반응발생정황。결과관찰조안조방안규정완성항병독치료적인수위29례(74.36%),대조조위19례(48.7%),관찰조완성솔고우대조조,차이유통계학의의(χ2=5.41,P<0.05)。관찰조평균완성주수위(32±8)주,대조조평균완성주수위(26±7)주,관찰조평균완성주수장우대조조,차이유통계학의의(t=3.52,P<0.05)。관찰조류감양증상화역격야등정서개변발생솔균저우대조조,차이유통계학의의(P<0.05)；갑상선공능이상、안통、위장도반응、기육관절통등기타불량반응발생솔여대조조비교차이무통계학의의(P>0.05)。연구중공유5례환자유명현초필、억욱증상,균발생재대조조。결론개성화호리간예유효해결료환자대간우소항HCV불량반응지식결핍적문제,유효완해병간환자유우불량반응소대래적부면정서,감경료정신이상발생적정도,증가료항병독치료적신심,제고료병간환자적의종성화지속응답솔。
Objective To improve the hepatitis C patients′ treatment compliance, and individualized interventions were conducted. Medical staffs and patients should work together to get longer and more sustained virological response. Methods A total of 78 patients with hepatitis C viral ( HCV) who participated in the clinical trail of pegylated recombinant interferon varian ( PEG-IFN-SA) were randomized into intervention group and control group during September 2011 to May 2012, 39 cases per group. At 4 weeks, 8 weeks and 12 weeks after treatment, 90 symptom checklist (SCL-90) questionnaires were tested among intervention group subjects, to know the problems about their society, family and metal health occurred throughout the treatment, then we coped with intervene targeted. The control group just visited according to protocol. Results In the intervention group, 29 (29/39,74. 36%) subjects completed the antiviral treatment, obviously higher than that of control group 19 (19/39, 48. 7%) (χ2 =5. 41,P<0. 05). The intervention group subjects completed treatment in (32 ±8) weeks, longer than that of control group (26 ±7) weeks (t=3.52,P<0.05). Influenza symptom and irritated emotion had low incidence in the intervention group than that of control group (P<0. 05); the incidences of abnormal thyroid function, eye pain, gastrointestinal reaction, muscle and joint pain and so other untoward effect had no statistical differences (P >0. 05). In the study, there were 5 cases represented the symptom of anxiety and depression in the control group. Conclusions The individualized nursing intervention can effectively solve the patients′ response to the AEs of interferon anti-HCV for lack related knowledge, effectively relieve the negative emotion of patients caused by the adverse reactions, reduce the degree of mental abnormality occurs, increase the confidence of antiviral treatment, and greatly improve the HCV patients′compliance, so as to improve the sustained response rate.