肝硬化患者发生轻微型肝性脑病现状及影响因素研究

doi:10.3761/j.issn.0254-1769.2020.06.015

摘要/Abstract

摘要：

目的探讨肝硬化患者发生轻微型肝性脑病的现况及影响因素。方法采用便利抽样法,对2017年6月—2018年12月入住上海市某三级甲等医院感染科的300例肝硬化患者,使用肝性脑病心理测试评分进行轻微型肝性脑病筛查,收集相关临床资料,经多因素Logistic回归分析发生轻微型肝性脑病的危险因素。结果 300例肝硬化患者中146例（48.67%）存在轻微型肝性脑病,年龄（OR=1.032）、国际标准化比值（OR=2.434）、血氨浓度（OR=1.793）、感染（OR=2.152）、肾功能不全（OR=1.904）和存在营养风险（OR=2.104）是主要影响因素（P<0.05）。结论年龄较大、国际标准化比值和血氨浓度升高,合并感染、肾功能不全和存在营养风险的肝硬化患者是发生轻微型肝性脑病的高危人群,应在护理评估中早期识别并予以预见性护理。

关键词: 轻微型肝性脑病, 肝硬化, 护理

Abstract:

Objective To investigate the current status of minimal hepatic encephalopathy（MHE） of patients with liver cirrhosis and to explore its risk factors. Methods From June 2017 to December 2018,totally 300 patients with liver cirrhosis were selected from a tertiary hospital in Shanghai via convenience sampling method,and were screened for MHE by psychometric hepatic encephalopathy score. Clinical data was analyzed by logistic regression model to determine the risk factors of MHE. Results The incidence of MHE was 48.67%（146 cases） in 300 liver cirrhosis inpatients;the logistic regression model showed that age（OR=1.032）,INR（OR=2.434）,blood ammonia（OR=1.793）,infection（OR=2.152）,renal insufficiency（OR=1.904）,nutritional risk（OR=2.104） were significant risk factors（P<0.05）. Conclusion Liver cirrhosis patients with older age,higher INR,higher blood ammonia,concurrent infection,renal insufficiency and nutritional risk are at high risk of developing MHE. Early detection and symptomatic interventions should be carried out.

Key words: Minimal Hepatic Encephalopathy, Liver Cirrhosis, Nursing Care

钱珠萍, 杨艳. 肝硬化患者发生轻微型肝性脑病现状及影响因素研究[J]. 中华护理杂志, 2020, 55(6): 872-876.

QIAN Zhuping, YANG Yan. Study on the current situation and risk factors of minimal hepatic encephalopathy in patients with liver cirrhosis[J]. Chinese Journal of Nursing, 2020, 55(6): 872-876.

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