授权教育饮食联合心理干预在病毒性肝炎后肝硬化中的应用

陈秀; 余建平; 翁芳芳; 潘孝本

doi:10.16766/j.cnki.issn.1674-4152.002642

授权教育饮食联合心理干预在病毒性肝炎后肝硬化中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002642

浙江大学医学院附属第二医院临平院区感染科，浙江杭州 311100

基金项目:

国家自然科学基金常规面上项目 82070610

详细信息

通讯作者:
余建平, E-mail: 3543725007@qq.com

中图分类号: R512.6 R473.51
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出版历程
- 收稿日期: 2022-01-12
- 网络出版日期: 2022-11-29

Authorised educational diet combined with psychological intervention in viral post-hepatitis cirrhosis

Department of Infectious Disease, Linping District, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 311100, China

摘要

摘要: 目的探讨授权教育饮食联合心理干预在病毒性肝炎后肝硬化患者中的应用效果。方法选取2020年1月—2021年1月浙江大学医学院附属第二医院临平院区感染科收治的病毒性肝炎后肝硬化患者120例，以随机数字表法分为研究组、对照组各60例。对照组按照常规护理流程进行干预，研究组在常规护理的基础上实施授权教育饮食联合心理干预，2组患者均干预3个月。观察比较2组患者干预前后健康知识与遵医行为评分，肝功能指标、营养状况指标。结果干预后，2组健康知识评分较干预前提高且研究组高于对照组，同时2组遵医行为评分较干预前提高且研究组高于对照组(均P＜0.05)；干预后，研究组患者ALT、总胆红素(TBIL)低于对照组[(51.03±6.62)U/L vs. (55.27±6.71)U/L，(54.87±8.54)μmol/L vs. (60.33±8.61)μmol/L，均P＜0.05]；研究组Alb、Hb、BMI水平高于对照组[(31.02±5.08)g/L vs. (21.56±4.78)g/L，(114.07±11.09)g/L vs. (101.95±10.87)g/L，21.25±2.04 vs.20.07±2.01，均P＜0.05]。结论给予病毒性肝炎后肝硬化患者授权教育饮食联合心理干预，可提高患者对疾病健康知识认知与遵医行为，改善营养状况，继而改善肝功能。
- 病毒性肝炎 /
- 肝硬化 /
- 授权教育 /
- 饮食干预 /
- 心理干预 /
- 肝功能 /
- 营养状况
Abstract: Objective To examine the effect of authorised educational diet combined with psychological intervention in viral post-hepatitic cirrhosis. Methods We selected a total of 120 patients with viral post-hepatitis cirrhosis who were admitted to the Department of Infectious Diseases, Linping Hospital, the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2020 to January 2021. They were randomly divided into a study group and a control group with 60 cases each through random-number-table method. The control group followed the routine nursing care, and the research group performed authorised education diet combined with psychological intervention for 3 months on the basis of routine nursing. Before and after the intervention, the relevant health knowledge and compliance behaviour of patients were scored, and liver-function index and nutritional-status index of patients were observed. Results After the intervention, the health knowledge score of the two groups was higher than that before the intervention, and the study group was higher than that of the control group, at the same time, the compliance behavior score of the two groups was higher than that before the intervention, and the study group was higher than that of the control group (all P < 0.05). After intervention, ALT and TBIL in the study group were lower than those in the control group [(51.03±6.62) U/L vs. (55.27±6.71) U/L, (54.87±8.54) μmol/L vs. (60.33±8.61) μmol/L, all P < 0.05]; The levels of Alb, Hb and BMI in the study group were higher than those in the control group [(31.02±5.08) g/L vs. (21.56±4.78) g/L, (114.07±11.09) g/L vs. (101.95±10.87) g/L, 21.25±2.04 vs. 20.07±2.01, all P < 0.05]. Conclusion Authorised education diet combined with psychological intervention for patients with viral post-hepatitis cirrhosis can improve their cognition of disease health knowledge and compliance behaviour, nutritional status, and liver function.
- Viral hepatitis /
- Cirrhosis /
- Authorised education /
- Dietary intervention /
- Psychological intervention /
- Liver function /
- Nutritional status

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表 1 2组病毒性肝炎后肝硬化患者一般资料比较

Table 1. Comparison of general data between two groups of patients with postviral hepatitis cirrhosis

组别	例数	性别(例)		年龄(x±s，岁)	肝功能分级(例)
组别	例数	男性	女性	年龄(x±s，岁)	A	B	C
研究组	60	36	24	60.81±7.90	19	26	15
对照组	60	34	26	60.23±7.85	18	25	17
统计量		0.137^a		0.260^b	0.356^c
P值		0.711		0.077	0.721
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组病毒性肝炎后肝硬化患者健康知识评分比较(x±s，分)

Table 2. Comparison of health knowledge scores between two groups of patients with posthiophotic viral hepatitis (x±s, points)

组别	例数	疾病认知		治疗认知		自护认知		饮食认知
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
研究组	60	12.35±3.50	20.38±3.55^a	13.58±3.42	21.40±3.67^a	10.05±2.84	21.51±3.35^a	9.85±2.05	20.43±3.26^a
对照组	60	12.60±3.65	16.85±3.50^a	13.45±3.39	18.35±3.60^a	10.11±2.75	18.68±3.27^a	9.77±2.08	17.67±3.24^a
t值		0.247	3.536	0.135	2.966	0.076	3.023	0.137	3.003
P值		0.781	0.001	0.795	0.006	0.852	0.005	0.794	0.006
注：与同组干预前比较，^aP＜0.05。

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表 3 2组病毒性肝炎后肝硬化患者遵医行为评分比较(x±s，分)

Table 3. Comparison of compliance scores between two groups of patients with posthiophotic viral hepatitis (x±s, points)

组别	例数	复诊		用药		饮食行为		自我护理
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
研究组	60	15.20±3.65	23.56±1.25^a	16.50±2.54	23.62±1.15^a	11.25±3.10	21.58±3.04^a	13.27±2.85	20.06±2.73^a
对照组	60	15.15±3.57	21.60±2.10^a	16.63±2.50	21.74±2.41^a	11.37±3.16	17.62±3.11^a	13.20±2.77	17.82±2.68^a
t值		0.049	4.010	0.182	3.520	0.136	4.553	0.088	2.927
P值		0.874	< 0.001	0.788	0.001	0.794	< 0.001	0.841	0.007
注：与同组干预前比较，^aP＜0.05。

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表 4 2组病毒性肝炎后肝硬化患者肝功能指标水平比较(x±s)

Table 4. Comparison of liver function indexes in two groups of patients with postviral hepatitis cirrhosis

组别	例数	ALT(U/L)		TBIL(μmol/L)
组别	例数	干预前	干预后	干预前	干预后
研究组	60	68.23±7.85	51.03±6.62^a	70.37±10.14	54.87±8.54^a
对照组	60	67.68±7.88	55.27±6.71^a	71.09±10.20	60.33±8.61^a
t值		0.247	2.249	0.250	2.251
P值		0.781	0.037	0.780	0.036
注：与同组干预前比较，^aP＜0.05。

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表 5 2组病毒性肝炎后肝硬化患者营养状态指标水平比较(x±s)

Table 5. Comparison of nutritional status indexes in two groups of patients with postviral hepatitis cirrhosis (x±s)

组别	例数	Alb(g/L)		Hb(g/L)		BMI
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
研究组	60	18.87±4.21	31.02±5.08^a	90.17±10.26	114.07±11.09^a	17.91±2.27	21.25±2.04^a
对照组	60	18.65±4.19	21.56±4.78^a	91.22±10.33	101.95±10.87^a	17.68±2.24	20.07±2.01^a
t值		0.185	2.480	0.361	3.902	0.361	2.060
P值		0.786	0.021	0.694	< 0.001	0.694	0.042
注：与同组干预前比较，^aP＜0.05。

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