目的:分析肝病患者发生低血糖的危险因素,根据相应的危险因素制定不同对策,减少此类患者发生低血糖的概率.方法:2018年1-9月收治出现低血糖反应(观察组)和未出现低血糖(对照组)的肝病患者各73例,对可能引起低血糖的相关因素进行分析,并探讨相应的预防措施.结果:经单因素分析,BMI指数过低、进食量少、无健康宣教、合并肝硬化、合并糖尿病、饮食结构不合理可能是导致肝病患者发生低血糖反应的危险因素.结论:医护人员应重视严重肝病患者血糖的管理,提高鉴别低血糖的能力,并给予相应的措施进行预防,可有效减少低血糖发生,同时发病后及时给予有效的治疗及干预,以促进患者恢复.

目的:了解深圳市第三人民医院4年来门诊就诊患者插队此种不规范就诊行为的原因分析及针对措施.方法:统计第三人民医院肝病门诊2010年1月—2013年12月来我院就诊有插队行为的患者,分析其插队的原因,为医院提供相应的解决措施.结果:7880例我院就诊患者中2010年就诊人数302人次?,2011年就诊1642人次,2012年就诊2300人次,2013年就诊3636人次.插队患者2010年发生15次,2011年发生105次,2012年发生240次,2013年发生505次;2010年插队发生率4.96％;2011年插队发生率6.39％;2012年插队发生率10.43％;2013年插队发生率13.88％;插队发生率每年逐渐升高;其中插队原因中:见别人插队也要求插队有405次,只是来开药插队要求先就诊234次,因自己是老病人,觉得因优先就诊109次,流程不熟悉而插队57次,有特殊原因如赶飞机等急事插队就诊138次,其他原因22次.不同性别、不同文化程度、不同年龄及不同病程的患者在是否会发生插队行为上也是有差异的;结论:我院每年门诊就诊量的提高,插队此种不规范就医行为的发生率也有所增加,其中插队原因中占最重要的是因别人插队也要求插队,男性、病程长、年龄大、文化程度低的患者比较容易发生插队行为.因此要针对引起插队的原因采取有效的针对措施,如增加专科门诊满足患者专门开药的要求;简单明了、简化就医流程;提供更多的指导、便民服务等,特别是针对那些年龄大、病程长的患者及时做好宣教和沟通,避免其发生插队的行为;从而提高患者就诊满意度,促进医患关系和谐发展.

目的:探讨随访工作对肝性脑病患者的依从性及再复发情况的影响,明确随访工作的重要性,并更好的指导和帮助患者.方法:将在2016年1月至2018年2年内我院住院期间,发生肝性脑病的患者纳入研究按分为对照组和对照组各60例,两组患者出院时均进行详细的告知及相关指导、注意事项;观察组患者出院后到慢病随访科登记并进行随访工作,时间为1周～3个月,对照组为未进行随访工作的患者;比较两组患者出院后依从性及再复发情况情况.结果:观察组患者出院后的依从性及再复发率均优于对照组,差异有计学意义(P<0.05).结论:长期随访工作能提高肝性脑病患者的依从性,以及降低肝性脑病的再复发情况.

Objective To investigate the related factors of anxiety in patients undergoing liver puncture,so as to provide better clinical care and psychological intervention for patients to ensure the successful completion of liver puncture. Methods From January 2008 to January 2014,310 cases of patients from the Third People's Hospital of Shenzhen with liver puncture were selected as the research object. The patients' general condition and self rating Anxiety Scale were investigated. Results The SAS score of the patients who would undergo liver puncture was(47.25±0.44)points,and the incidence of anxiety symptoms was 91.3%. The results of univariate and multivariate analysis showed that the effect of patients with anxiety before liver biopsy can explain the variation of the size of the corresponding factors:whether accompanied by family members, payment methods,awareness of the disease,ear of liver failure,the education level,and gender(β' =0.617, 0.352,0.114,0.102,0.082、0.043;P < 0.05). Conclusions Before the liver puncture,the patients show a state of anxiety. The main factors affecting the anxiety status are whether to have family members,to pay for the disease,to understand the disease,to worry about the failure of liver failure,the degree of education and gender medical staff should provide targeted nursing intervention for patients to alleviate anxiety and promote rehabilitation on the basis of the above factors and the relevant circumstances.

ObjectiveTo investigate the influencing factors and nursing experiences of patients who underwent liver biopsy.Methods Total of 510 patients who underwent liver biopsy from January 2000 to January 2011 in Guangdong Medical College afifliated to Shenzhen Third People’s Hospital were selected. Effects of gender, age and whether accompanied by family members on pain, blood pressure, anxiety and adverse reactions of the patients were compared. The anxiety level was assessed by Zung Self-rating Anxiety Scale (SAS) measurement, and the degree of pain in the liver area was assessed by the McGill question and answer classiifcation.Results①The changes of blood pressure, the degree of pain and the anxiety were more obvious of female patients than those in male patients, the differences were statistically signiifcant (P< 0.05), and there was no significant difference in adverse reactions (χ2 = 1.213,P = 0.271).②Change of blood pressure, liver area pain sense, anxiety level and adverse reactions occurred in patients with ages≥ 40 years old were more obvious than those of patients with ages< 40 years old, and the differences were statistically significant (P< 0.05).③Patients with no family accompanied in the changes of blood pressure, liver area pain and anxiety level were more obvious than those in patients with family members accompanied, the differences were statistically signiifcant (P< 0.05), and there was no signiifcant difference in adverse reactions (χ2 = 0.332,P = 0.564).Conclusions For women patients, who were older than 40 years old and&nbsp;without family accompanying, the pain in the liver area, blood pressure changes, anxiety, adverse effects were more obvious in liver biopsy. For these patients, propaganda, education, psychological intervention, emotional counseling and full care should be done by the nurse before the operation, and the condition changes of the patient should be monitored closely.

Objective To observe and explore the effect of psychological nursing combine with humanistic care on hepatitis B ( CHB) patients with negative mental status. Methods A total of 100 cases of patients with CHB were given psychological nursing with humanistic care nursing intervention on the basis of the routine care in our hospital from May 2013 to April 2014 as the intervention group, while 100 cases with CHB in our hospital for treatment and nursing at previous year were selected as control group. Hamilton Depression Rating Scale ( HAMD) , Hamilton Anxiety Rating Scale ( HAMA) and Pittsburgh Sleep Quality Index Scale ( PSQI) were used to assess the depression, anxiety and sleep quality of the two groups. The treatment compliance of the two groups were recorded and compared. Results The scores of HAMD, HAMA and PSQI in the two groups before nursing were not statistically significant ( P>0. 05) . The scores of HAMD, HAMA and PSQI in the intervention group were (22. 8 ± 6. 8) points, (25. 2 ± 8. 4) points and (24. 3 ± 9. 3) points, while in the control group were (43. 1 ± 9. 3) points, (40. 7 ± 10. 8) points and (38. 6 ± 10. 2) points, the differences were statistically significant (P<0. 05) . The ratio of quit smoking and drinking, compli-ance of medication, the law of life, and the proportion of regular review in intervention group after care were significantly higher than those of control group ( P<0. 05 ) . Conclusion Psychological nursing combine with humanistic care inter-vention can significantly improve the psychological status and sleep quality of CHB patients, beneficial to the patients' treatment compliance.