关键词: 肝硬化, 肝性脑病, 降低风险行为, 预测, 护理

Abstract:

Objective To explore the risk factors associated with hepatic encephalopathy in patients with cirrhosis and evaluate the effects of a prediction model.Methods A total of 276 cirrhotic patients in a tertiary hospital were involved from July to September in 2018,and indicators of hepatic encephalopathy group (n=31) and non-hepatic encephalopathy group(n=245) were compared. The prediction model was developed by independent risk factors,and the model to predict the effects were tested by the area under the ROC cure.Results The study found that previous hepatic encephalopathy,total bilirubin,transjugular intrahepatic portosystemic shunt and hepatorenal syndrome were the independent factors of hepatic encephalopathy. Based on these independent risk factors,a predicted model for hepatic encephalopathy in cirrhotic patients was constructed. The model was P=e ^x/(1+e ^x),and X=-3.791 +2.19 × previous hepatic encephalopathy+0.685 × total bilirubin+2.490 × transjugular intrahepatic portosystemic shunt+2.914 × hepatorenal syndrome. The area under the ROC curve of this model was 0.840(95%CI：0.757~0.924),with the sensitivity of 0.839,the specificity of 0.776. And the verification of this prediction model showed the sensibility of 90.5%,the specificity of 85.0% and the accuracy of 85.5%,showing the effects of this model were satisfied.Conclusion The prediction model of hepatic encephalopathy has satisfactory prediction effects. It can be used to predict the risk of hepatic encephalopathy in cirrhosis patients,providing the reference for management and preventative treatment for high-risk cirrhosis patients.

Key words: Liver Cirrhosis, Hepatic Encephalopathy, Risk Reduction Behavior, Forecasting, Nursing Care