心理干预对慢性肝损伤患者保肝治疗的影响

论文编号:HL217 论文字数:19829,页数:32

论文题目：心理干预对慢性肝损伤患者保肝治疗的影响
摘 要
 随着慢性肝损伤在我国发病率的逐年增长，患者多因病程迁延，不易治愈，思想负担重、治疗费用高从而导致其保肝治疗的效果不佳，生存质量明显下降。如何增强保肝治疗的效果，提高生存质量一直是护理学研究的方向。而心理干预能够增强慢性肝损伤患者保肝治疗的效果，提高其生存质量，缩短保肝治疗的时间，降低治疗费用提升治愈率，同时提高患者对护理工作的认同感和护理人员的成就感，拓展护理工作的内涵有重要意义，因此本研究具有意义。在护理工作中，将心理干预应用于慢性肝损伤患者保肝治疗的全程中，结合科学合理的医疗方法，明显增强了患者保肝治疗的效果，提高了生存质量。
研究目的：
 探讨心理干预对慢性肝损伤患者保肝治疗效果的影响。
 研究方法：
 本研究采用随机抽样的方法，选取西安地区慢性肝损伤患者为调查对象，将60例慢性肝损伤患者依据采样工具、统计方法随机分为实验组和对照组两组，实验组实施心理干预和常规治疗，对照组实施一般常规门诊治疗护理，观察各组患者实施不同干预措施后的焦虑、抑郁情绪状况，肝功能恢复情况、治愈率、治疗时间和费用。所得结果采用SPSS16.0软件进行统计学分析，统计方法为t检验和χ2检验。
 研究结果：
    实验组患者心理干预后的焦虑评分为33.45±6.50，对照组为46.39±8.91, 与对照组比较差异有统计学意义（t=6.07，P＜0.01）。实验组患者心理干预后的抑郁评分为39.00±12.67，对照组为50.10±11.00，与对照组比较差异有统计学意义（t=4.80，P＜0.01）。
 实验组患者心理干预后肝功能ALT为25.8±35.1u/l,对照组为86.5±38.7u/l，差异有统计学意义（t=9.24，P＜0.01）；实验组肝功能AST为29.3±23.1u/l,对照组为52.0±34.8 u/l，差异有统计学意义（t=4.36，P＜0.01）。
 实验组患者治疗时间为25±5天，对照组为40±5天，实验组较对照组治疗时间明显缩短，差异有统计学意义（t=16.44   P＜0.01）。
 实验组治疗费用为99.44±15.41元，对照组为138.66±15.41元, 实验组较对照组治疗费用明显降低，差异有统计学意义（t=13.95   P＜0.01）。
 实验组和对照组患者的治愈率分别为83.33%和56.67%，两组患者治愈率情况实验组明显优于对照组，差异有统计学意义（x2=6.54，P＜0.01）。
 结论：
 对慢性肝损伤患者实施心理干预,可提高肝功能恢复率，缩短保肝治疗的时间，降低治疗费用。
 
 
论文类型：应用研究
关 键 词：心理干预；慢性肝损伤；保肝治疗
 
 Title: The effect of psychological intervention on the treatment of protecting liver in patients with chronic liver injury

ABSTRACT
 Along with the increasing incidence of chronic liver injury year by year in our country, the quality of life of the patients decreased obviously due to the delayed course of disease, difficult curing, heavy burden of mind of the patients, high cost of treatment, resulting in poor effect of the method of protecting liver. How to improve the therapeutic effect of protecting liver and the quality of life has been the orientation in nursing study. Psychological intervention, however, is capable of enhancing the therapeutic effect in patients with chronic liver injury, improving the quality of life, shortening the duration of treatment, reducing the cost as well as improving the social identity to nursing and the achievement of nurse staff, which is very significant in this study. The therapeutic effect and the quality of life of patients were greatly improved by means of psychological intervention in the whole course of treatment of protecting liver in patients with chronic liver injury, and combining with the scientific and rational medical care in nursing practice.

Objective：Studying the effect of psychological intervention on the treatment of protecting liver in patients with chronic liver injury.

Method：The objects in this study were patients with chronic liver injury, who were randomly sampled from Xi’an district. 60 cases were randomly divided into testing and control groups by way of sampling means and statistical method. Psychological intervention and routine treatment were practised in testing group while general routine clinical nursing were carried out in control group. The conditions of anxiety and depression emotion, recovery of liver funtion, duration and cost of treatment were observed in both groups. The results were analysed statistically by  SPSS16.0 software and the method were t and χ2.

Results：After mental intervention, the anxiety grade in patients of the experimental group is 33.45±6.50,the control group is 46.39±8.91, correlation between the two groups has significantly difference(t=6.07,P＜0.01).And the depression grade in patients of the experimental group is 39.00±12.67,the control group is 50.10±11.00, correlation of the two groups has significantly difference(t=4.80,P＜0.01).
 After mental intervention, the liver function(ALT) in patients of the experimental group is25.8±35.1U/L, the control group is 86.5±38.7U/L, correlation between them has significantly difference(t=9.24,P＜0.01).And the liver function(AST) in patients of the experimental group is29.3±23.1U/L, the control group is 52.0±32.8U/L, correlation of the two groups has significantly difference(t=4.36,P＜0.01).
 The cure time in patients of the experimental group is25±5 days, the control group is 40±5 days, the cure time in patients of the experimental group is distinctly abbreviate, correlation between them has significantly difference(t=16.44,P＜0.01).
 The expense in patients of the experimental group is99.44±15.41 yuan, the control group is138.66±15.41 yuan , the expense in patients of the experimental group is clearly reduction, correlation between them has significantly difference(t=13.95,P＜0.01).
 The cure rate in patients of the experimental group is83.66%, the control group is56.67%, the cure rate in patients of the experimental group is positively excelled the control group, correlation between them has significantly difference(x2=6.54,P＜0.01).

Conclusion：Psychological intervention is capable of enhancing the therapeutic effect of protecting liver in patients with chronic liver injury, bringing about positive impact, improving the quality of life, shortening the duration of treatment and reducing the cost.

TYPE OF THESIS： application research

KEY WORDS：Psychological intervention；Chronic Liver injury；Protecting liver therapy
  
 
目  录
摘 要 Ⅰ
ABSTRACT Ⅲ
目  录 Ⅴ
1. 绪论 1
 1.1背景及意义 1
 1.2.研究目的及目标 1
 1.3.关键词及定义 2
 1.3.1心理干预 2
 1.3.2慢性肝损伤 2
 1.3.3保肝治疗
 1.4文献回顾 2
 1.4.1心理干预 2
 1.4.2慢性肝损伤 5
 1.4.3保肝治疗 6
2.研究的对象和方法 9
 2. 1 研究对象和抽样 9
 2.1.1研究对象选择 9
 2.1.2抽样方法 9
 2.2研究方法 9
 2.2.1 研究设计 9
 2.2.2 研究工具 9
 2.2.3干预方法 10
 2.2.4 评价指标 12
 2.3研究步骤 12
 2.3.1 抽样分组 12
 2.3.2 调查原选取和培训 12
 2.3.3 实施干预 12
 2.3.4 收集资料 12
 2.3.5 资料分析 13
 2.4调查成果分析 13
3.研究结果 14
 3. 1两组患者心理干预前后焦虑情绪比较 14
 3. 2两组患者心理干预前后抑郁情绪比较 14
 3.3两组患者治疗前后肝功能比较 15
 3.4两组患者治疗时间比较 15
 3.5两组患者治疗费用比较 16
 3.6两组患者治愈率比较 16
4.讨论 17
 4.1针对性的心理干预对减轻患者焦虑状况的影响 17
 4.2针对性的心理干预对减轻患者抑郁状况的影响 17
 4.3针对性的心理干预对恢复患者肝功能状况的影响 17
 4.4针对性的心理干预对缩短患者治疗时间的影响 17
 4.5针对性的心理干预对降低患者治疗费用的影响 17
 4.6针对性的心理干预对提升患者治愈率的影响 18
5.推论及建议 19
 5.1推论 19
 5.2建议 19
致 谢 21
参考文献 23
附件 25