| 韦琳,刘诗光.肝移植术后患者精神异常的影响因素与护理对策[J].上海护理,2015,15(1): |
| 肝移植术后患者精神异常的影响因素与护理对策 |
| The influencing factor and nurse strategy of abnormal mental status after liver transplantation WEI Lin, LIU Shi-guang. Ruijin hosptial, Shanghai Jiaotong University, Shanghai 200025, China |
| DOI： |
| 中文关键词: 肝移植 精神异常 影响因素 护理对策 |
| 英文关键词:Liver transplantation Abnormal mental status Nurse strategy |
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| 中文摘要: |
| 目的：探讨引起肝移植术后患者精神异常的相关因素及护理对策。方法：收集肝移植患者371例,对有精神异常( 观察组)和无精神异常( 对照组)患者的临床资料,选择病史、术前Child 评分、无肝时间、手术时间、出血量、术后ICU 天数、FK-506 浓度等等临床因素进行比较分析,并用Richard镇静一激越评分系统(SAS)对患者的精神状态进行评价。SAS评分在5级以上者诊断为精神状态异常,用统计学方法对所得数据进行分析。结果：371例患者中出现术后精神异常74例(19.9% ),观察组与对照组在无肝期时间、总手术时间、同时期的血药浓度等方面无显著性差异(P > 0. 05)；术前Child 评分高、有肝性脑病史、术中出血量多的患者,在ICU 时间长的患者,术后精神异常的发生率较高。经相应处理及精心护理后,精神异常症状消失。结论: 肝移植术后早期发生精神异常是多种因素联合作用的结果,加强护理支持与安全管理可促进精神状态的恢复,提高肝移植手术的成功率。 |
| 英文摘要: |
| Objective To discuss the cause of abnormal metal status after liver transplantation and the relative nurse strategy. Methods 371 cases of liver transplantation were collected in this study, abnormal mental patients were assigned into Observation group and normal metal patients were assigned into Contrast group, comparison analysis was carried out between these two groups on the following clinical features: patient selection , preoperative Child score, anhepatic time, operation time, blood loss, postoperative ICU time, FK-506 concentration. The mental status was evaluated everyday by Richard"s sedation-activation scoring system (SAS). The patients were considered as abnormal mental status if SAS score exceeded grade 5. The data were analyzed by statistics. Results 74 (19.9%) patients experienced abnormal mental status after liver transplantation in 371 cases. There were no obvious difference between Observation group and Contrast group in anhepatic time,total operation time and blood drug concentration (PS>S0.S05). High preoperative Child score, history of hepatic encephalopathy, large volume of blood loss, long time at ICU were positively related to abnormal mental status after liver transplantation. The abnormal mental status disappeared after appropriate treatment and intensive nursing. Conclusions SThe abnormal mental status at early stage after liver transplantation was resulted in a combination of multiple factors, enhanced nursing support and safety management can promote the recovery of the mental status, contribute to improve the success rate of liver transplantation. |
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