中国典型病例大全

目的 探讨综合护理干预对肝硬化腹水患者腹水消退、肝功能相关指标及治疗依从性的影响。方法 选取2025年1月—2025年12月广元市第一人民医院收治的60例肝硬化腹水患者为研究对象，按随机数字表法将其分为对照组与观察组，各30例。对照组实施常规护理，观察组在对照组基础上实施综合护理干预。比较两组的腹水消退相关指标、肝功能相关指标、Child-Pugh评分、并发症发生情况及治疗依从性。结果 观察组腹水消退时间、住院时间均短于对照组，24 h尿量多于对照组，腹围缩小值大于对照组（P<0.05）。重复测量方差分析显示，两组血清白蛋白、总胆红素、凝血酶原时间及Child-Pugh评分的时间效应差异均有统计学意义（P<0.05），各指标的时间与组别交互效应差异均有统计学意义（P<0.05）。护理前，两组血清白蛋白、总胆红素、凝血酶原时间、Child-Pugh评分比较，差异无统计学意义（P>0.05）；护理后，观察组血清白蛋白高于对照组，总胆红素、Child-Pugh评分均低于对照组，凝血酶原时间短于对照组（P<0.05）。观察组并发症发生率为13.33%，低于对照组的46.67%，治疗依从率为93.33%，高于对照组的66.67%（P<0.05）。结论 综合护理干预可加快肝硬化腹水患者腹水消退，改善其肝功能，减少并发症发生情况，提高治疗依从性，具有较好的临床应用价值。

Objective To explore the effects of comprehensive nursing intervention on ascites regression， liver function related indicators and treatment compliance in patients with cirrhosis ascites. Methods A total of 60 patients with cirrhosis ascites who were admitted to Guangyuan First People's Hospital from January 2025 to December 2025 were selected as the research objects. According to the random number table method， they were divided into the control group and the observation group， with 30 cases in each group. The control group was given routine nursing， and the observation group was given comprehensive nursing intervention on the basis of the control group. The ascites subsidence related indicators， liver function related indicators， Child-Pugh score， complications and treatment compliance were compared between the two groups. Results The ascites subsidence time and hospital stay in the observation group were shorter than those in the control group， 24 h urine volume was more than that in the control group， and the abdominal circumference reduction value was greater than that in the control group（P<0.05）. Repeated measurement analysis of variance showed that the time effects of serum albumin， total bilirubin， prothrombin time and Child-Pugh score in the two groups were statistically significant（P<0.05）， and the interaction effects of time and group of each index were statistically significant（P<0.05）. Before nursing， there were no statistically significant differences in serum albumin， total bilirubin， prothrombin time and Child-Pugh score between the two groups（P>0.05）. After nursing， the serum albumin of the observation group was higher than that of the control group， the total bilirubin and Child-Pugh score were lower than those of the control group， and the prothrombin time was shorter than that of the control group（P<0.05）. The incidence of complications in the observation group was 13.33%， which was lower than 46.67% in the control group， and the treatment compliance rate was 93.33%， which was higher than 66.67% in the control group（P<0.05）. Conclusion Comprehensive nursing intervention can accelerate the subsidence of ascites in patients with liver cirrhosis ascites， improve their liver function， reduce the incidence of complications， and improve treatment compliance， which has good clinical application value.