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聚乙二醇化重组集成干扰素变异体治疗丙肝患者致精神不良反应的临床观察与心理干预
  • ISSN号:1674-2907
  • 期刊名称:《中华现代护理杂志》
  • 时间:0
  • 分类:R512.63[医药卫生—临床医学;医药卫生—内科学]
  • 作者机构:[1]吉林大学第一医院Ⅰ期药物临床试验病房,长春130021, [2]吉林大学第一医院干部病房,长春130021, [3]吉林大学白求恩医学院,长春130021
  • 相关基金:国家自然科学基金(81172726)
中文摘要:

目的:通过个体化护理干预方法,提高丙型肝炎患者抗病毒治疗的依从性,医患共同努力以获得更加长久和持续的病毒学应答。方法2011年9月—2012年5月将78例参加聚乙二醇化重组集成干扰素变异体( PEG-IFN-SA )临床试验的慢性丙型肝炎受试者随机分为观察组和对照组,每组39例。对照组按研究方案要求正常回访。观察组在给药后4,8,12,24周给予90项症状清单(SCL-90)问卷测试,了解每个患者在治疗过程中出现的社会、家庭、身心健康等方面的问题,针对性地进行护理干预。比较两组患者抗病毒治疗的完成情况和不良反应发生情况。结果观察组按照方案规定完成抗病毒治疗的人数为29例(74.36%),对照组为19例(48.7%),观察组完成率高于对照组,差异有统计学意义(χ2=5.41,P〈0.05)。观察组平均完成周数为(32±8)周,对照组平均完成周数为(26±7)周,观察组平均完成周数长于对照组,差异有统计学意义(t=3.52,P〈0.05)。观察组流感样症状和易激惹等情绪改变发生率均低于对照组,差异有统计学意义(P〈0.05);甲状腺功能异常、眼痛、胃肠道反应、肌肉关节痛等其他不良反应发生率与对照组比较差异无统计学意义(P〉0.05)。研究中共有5例患者有明显焦虑、抑郁症状,均发生在对照组。结论个性化护理干预有效解决了患者对干扰素抗HCV不良反应知识缺乏的问题,有效缓解丙肝患者由于不良反应所带来的负面情绪,减轻了精神异常发生的程度,增加了抗病毒治疗的信心,提高了丙肝患者的依从性和持续应答率。

英文摘要:

Objective To improve the hepatitis C patients′ treatment compliance, and individualized interventions were conducted. Medical staffs and patients should work together to get longer and more sustained virological response. Methods A total of 78 patients with hepatitis C viral ( HCV) who participated in the clinical trail of pegylated recombinant interferon varian ( PEG-IFN-SA) were randomized into intervention group and control group during September 2011 to May 2012, 39 cases per group. At 4 weeks, 8 weeks and 12 weeks after treatment, 90 symptom checklist (SCL-90) questionnaires were tested among intervention group subjects, to know the problems about their society, family and metal health occurred throughout the treatment, then we coped with intervene targeted. The control group just visited according to protocol. Results In the intervention group, 29 (29/39,74. 36%) subjects completed the antiviral treatment, obviously higher than that of control group 19 (19/39, 48. 7%) (χ2 =5. 41,P〈0. 05). The intervention group subjects completed treatment in (32 ±8) weeks, longer than that of control group (26 ±7) weeks (t=3.52,P〈0.05). Influenza symptom and irritated emotion had low incidence in the intervention group than that of control group (P〈0. 05); the incidences of abnormal thyroid function, eye pain, gastrointestinal reaction, muscle and joint pain and so other untoward effect had no statistical differences (P 〉0. 05). In the study, there were 5 cases represented the symptom of anxiety and depression in the control group. Conclusions The individualized nursing intervention can effectively solve the patients′ response to the AEs of interferon anti-HCV for lack related knowledge, effectively relieve the negative emotion of patients caused by the adverse reactions, reduce the degree of mental abnormality occurs, increase the confidence of antiviral treatment, and greatly improve the HCV patients′compliance, so as to improve the sustained response rate.

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期刊信息
  • 《中华现代护理杂志》
  • 中国科技核心期刊
  • 主管单位:中国科学技术协会
  • 主办单位:中华医学会
  • 主编:沈藜
  • 地址:北京市宣武区宣武门外大街香炉营东巷2号院1号楼7单元301室
  • 邮编:100051
  • 邮箱:cimn@cimn.net
  • 电话:010-83191170/1
  • 国际标准刊号:ISSN:1674-2907
  • 国内统一刊号:ISSN:11-5682/R
  • 邮发代号:82-352
  • 获奖情况:
  • 国内外数据库收录:
  • 被引量:40634