[摘要]目的 探討血漿吸附治療嚴重多發(fā)傷并發(fā)重度淤膽型肝炎的護理干預措施。方法 選取2012年5月～2017年5月我院收治的嚴重多發(fā)傷并發(fā)重度淤膽型肝炎患者12例，隨機分為兩組，對照組應用保肝、降低膽紅素等基礎治療并結合常規(guī)護理，研究組應用基礎治療基礎上聯(lián)合經(jīng)血漿吸附治療并加強護理干預，比較總膽紅素（DB）和直接膽紅素（TB）水平，不同階段谷丙轉氨酶（ALT）。結果 干預前兩組患者DB、TB水平無明顯差異（P>0.05）；干預后研究組DB、TB水平低于對照組（P<0.05），干預前兩組無明顯差異（P>0.05），干預后研究組ALT水平低于對照組（P<0.05）。結論 嚴重多發(fā)傷并發(fā)重度淤膽型肝炎患者的治療過程中，血漿吸附的治療效果理想，加強護理干預后，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，臨床上應當進一步推廣應用。
　　[關鍵詞] 血漿吸附；嚴重多發(fā)傷；并發(fā)；重度淤膽型肝炎；護理
　　[中圖分類號] R473.6 [文獻標識碼] B [文章編號] 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
　　嚴重多發(fā)傷一般是指在事故發(fā)生之后，因為同一個致傷原因使人體兩個以上的臟器或者是解剖部位發(fā)生情況嚴重的損傷[1]。嚴重多發(fā)傷患者在早期對損傷進行控制和外科處理與治療復蘇后，仍有一定幾率發(fā)生氣管功能性障礙而發(fā)生死亡[2]。嚴重多發(fā)傷之后患者肝膽在沒有直接發(fā)生損傷或是膽道梗阻情況下，會發(fā)生氨基轉移酶升高為主要特征的肝細胞性黃疸，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后情況并不理想[3]。血漿吸附治療是通過對血漿分離及特異性吸附儀器，將血漿或是全血當中的特定物質進行吸附的情況。我院在嚴重多發(fā)傷并發(fā)重度淤膽型肝炎患者臨床治療中應用血漿吸附方法進行治療并加強護理干預措施，效果理想，現(xiàn)報道如下。

相關熱詞搜索：血漿 吸附 肝炎 并發(fā) 干預