血漿吸附治療嚴(yán)重多發(fā)傷并發(fā)重度淤膽型肝炎的護(hù)理干預(yù)措施研究

　　[摘要]目的 探討血漿吸附治療嚴(yán)重多發(fā)傷并發(fā)重度淤膽型肝炎的護(hù)理干預(yù)措施。方法 選取2012年5月～2017年5月我院收治的嚴(yán)重多發(fā)傷并發(fā)重度淤膽型肝炎患者12例，隨機(jī)分為兩組，對(duì)照組應(yīng)用保肝、降低膽紅素等基礎(chǔ)治療并結(jié)合常規(guī)護(hù)理，研究組應(yīng)用基礎(chǔ)治療基礎(chǔ)上聯(lián)合經(jīng)血漿吸附治療并加強(qiáng)護(hù)理干預(yù)，比較總膽紅素（DB）和直接膽紅素（TB）水平，不同階段谷丙轉(zhuǎn)氨酶（ALT）。結(jié)果 干預(yù)前兩組患者DB、TB水平無(wú)明顯差異（P>0.05）；干預(yù)后研究組DB、TB水平低于對(duì)照組（P<0.05），干預(yù)前兩組無(wú)明顯差異（P>0.05），干預(yù)后研究組ALT水平低于對(duì)照組（P<0.05）。結(jié)論 嚴(yán)重多發(fā)傷并發(fā)重度淤膽型肝炎患者的治療過(guò)程中，血漿吸附的治療效果理想，加強(qiáng)護(hù)理干預(yù)后，患者總膽紅素及直接膽紅素水平明顯降低，患者病情得到明顯改善，臨床上應(yīng)當(dāng)進(jìn)一步推廣應(yīng)用。
　　[關(guān)鍵詞] 血漿吸附；嚴(yán)重多發(fā)傷；并發(fā)；重度淤膽型肝炎；護(hù)理
　　[中圖分類號(hào)] R473.6 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2018）08-0150-03
　　Nursing intervention measures of plasma adsorption therapy in treating severe multiple injury combined with severe cholestatic hepatitis
　　GAO Hong
　　Department of Liver Diseases and Oncology， Shenyang Sixth People"s Hospital， Shenyang 110000，China
　　[Abstract] Objective To investigate the nursing interventions of plasma adsorption in the treatment of severe multiple injury combined with severe cholestatic hepatitis. Methods 12 patients with severe multiple injury complicated with severe cholestatic hepatitis treated in our hospital from May 2012 to May 2017 were randomly divided into two groups. The control group was treated with basic therapy such as hepatoprotective and bilirubin reduction combined with routine nursing. The study group was treated with plasma adsorption therapy and strengthened nursing intervention based on the basic treatment. The levels of DB （total bilirubin）， TB （direct bilirubin） and ALT （alanine aminotransferase） of different stages were compared. Results There was no significant difference in the levels of DB and TB in the two groups before intervention（P>0.05）. After intervention， the levels of DB and TB in the study group were lower than those in the control group （P<0.05）. There was no significant difference between the two groups before intervention（P>0.05）. The level of ALT in the study group was lower than that in the control group after intervention （P<0.05）. Conclusions Plasma adsorption has a satisfactory treatment effect in the patients with severe multiple traumatic injury complicated with severe cholestatic hepatitis. After strengthening nursing intervention， the patients" total bilirubin and direct bilirubin levels are significantly reduced， and the patient"s condition is significantly improved. The application of nursing interventions should be further promoted clinically.
　　[Key words] Plasma adsorption； Severe multiple injuries； Complicating； Severe cholestatic hepatitis； Nursing
　　嚴(yán)重多發(fā)傷一般是指在事故發(fā)生之后，因?yàn)橥�一個(gè)致傷原因使人體兩個(gè)以上的臟器或者是解剖部位發(fā)生情況嚴(yán)重的損傷[1]。嚴(yán)重多發(fā)傷患者在早期對(duì)損傷進(jìn)行控制和外科處理與治療復(fù)蘇后，仍有一定幾率發(fā)生氣管功能性障礙而發(fā)生死亡[2]。嚴(yán)重多發(fā)傷之后患者肝膽在沒(méi)有直接發(fā)生損傷或是膽道梗阻情況下，會(huì)發(fā)生氨基轉(zhuǎn)移酶升高為主要特征的肝細(xì)胞性黃疸，但是并發(fā)重度淤膽型肝炎的情況較為少見，并且藥物臨床治療效果和患者預(yù)后情況并不理想[3]。血漿吸附治療是通過(guò)對(duì)血漿分離及特異性吸附儀器，將血漿或是全血當(dāng)中的特定物質(zhì)進(jìn)行吸附的情況。我院在嚴(yán)重多發(fā)傷并發(fā)重度淤膽型肝炎患者臨床治療中應(yīng)用血漿吸附方法進(jìn)行治療并加強(qiáng)護(hù)理干預(yù)措施，效果理想，現(xiàn)報(bào)道如下。

相關(guān)熱詞搜索：血漿 吸附 肝炎 并發(fā) 干預(yù)