CAJ | 학술논문

目的了解肝硬化并发上消化道出血患者的自我护理能力水平和短期生存状况,并分析两者的相关性.方法第一阶段,选取我院2013年7月至2014年7月收治的78例肝硬化首次并发上消化道出血患者作为研究对象,采用自我护理能力测定量表对患者的自我护理能力进行测评,并分析结果.第二阶段,对78例研究对象按自我护理能力得分占总分比例分为低水平、中等水平、高水平3组.采用前瞻性研究设计,通过电话随访和门诊随访,收集患者评价指标,比较3组患者出院3个月生存状况的差异.结果肝硬化并发上消化道出血住院患者自我护理能力得分总分为(84.07±17.38)分,选择的78例患者中,12例占15.4％处于低水平,59例占75.6％处于中等水平,7例占9.0％处于高水平;出院后3个月内,低等组病死率8/12,中等组病死率33.9％(20/59),高等组病死率1/7,整体对比组间差异具有统计学意义∥=6.3,P＜ 0.05;MELD-Na评分系统得分低等组为(34.03±4.62)分,中等组为(22.57±3.05)分,高等组为(12.87±1.36)分,3组间比较差异具有统计学意义,F=6.0,P＜0.05;3组患者并发症发生率与自我护理能力得分相关系数为-(0.525～0.189),两者呈负相关.结论肝硬化并发上消化道出血患者自我护理能力水平整体处于中等水平,患者的自我护理能力对预后有一定的影响,临床工作中需要重视患者自我护理能力的培养.
목적 료해간경화병발상소화도출혈환자적자아호리능력수평화단기생존상황,병분석량자적상관성.방법 제일계단,선취아원2013년7월지2014년7월수치적78례간경화수차병발상소화도출혈환자작위연구대상,채용자아호리능력측정량표대환자적자아호리능력진행측평,병분석결과.제이계단,대78례연구대상안자아호리능력득분점총분비례분위저수평、중등수평、고수평3조.채용전첨성연구설계,통과전화수방화문진수방,수집환자평개지표,비교3조환자출원3개월생존상황적차이.결과 간경화병발상소화도출혈주원환자자아호리능력득분총분위(84.07±17.38)분,선택적78례환자중,12례점15.4％처우저수평,59례점75.6％처우중등수평,7례점9.0％처우고수평;출원후3개월내,저등조병사솔8/12,중등조병사솔33.9％(20/59),고등조병사솔1/7,정체대비조간차이구유통계학의의∥=6.3,P＜ 0.05;MELD-Na평분계통득분저등조위(34.03±4.62)분,중등조위(22.57±3.05)분,고등조위(12.87±1.36)분,3조간비교차이구유통계학의의,F=6.0,P＜0.05;3조환자병발증발생솔여자아호리능력득분상관계수위-(0.525～0.189),량자정부상관.결론 간경화병발상소화도출혈환자자아호리능력수평정체처우중등수평,환자적자아호리능력대예후유일정적영향,림상공작중수요중시환자자아호리능력적배양.
Objective To investigate the self-care agency level and analysis the relationship between the self-care ability level and the prognosis of the patients with upper gastrointestinal bleeding caused by liver cirrhosis.Methods In the first stage,78 cases of liver cirrhosis patients complicated with first eruption of upper gastrointestinal bleeding were selected,the Exercise of Self Care Agency Scale (ESCA)was adopted to assess the self care ability of patients,the results underwent analysis.In the second stage,according to the results that the proportion of scores accounted for total score ratio,the patients were divided into low,medium and high level groups.By prospective studies,through telephone follow-up and clinic follow-up,the evaluation items of patients were collected,and the survival status of patients within 3 months after discharge was compared.Results For patients with upper digestive tract bleeding caused by liver cirrhosis,the self-care scored (84.07±17.38) totally,among 78 patients selected,15.4％ (12/78) was in the low level,75.6％ (59/78) was in the medium level,9.0％ (7/78) was in the high level.The self-care ability increased in conjunction with decreased mortality rate.The mortality rate in the lower level group was 8/12,33.9％ (20/59) in the medium level group,1/7 in the higher level group,there was statistically significant difference,x2=6.3,P＜0.05.The MELD-Na scores in the lower,medium and higher level groups wererespectively 34.03±4.62,22.57±3.05,12.87±1.36,F=6.0,P＜0.05.Likewise,complication incidence rates were negatively correlated with self-care ability,r =-(0.525-0.189).Conclusions The self-care ability of patients with gastrointestinal bleeding caused by liver cirrhosis is in the medium level,and it exercises certain influence on prognosis of patients.Attention should be paid to cultivation of self-care ability of patients in clinic.