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应用凯时预防慢性重症肝炎并发肝肾综合征的观察及护理
肝肾综合征是指严重肝脏疾病且排除原发性肾脏疾病情况下,短时间内发展成功能性肾衰竭.慢性重症肝炎极易发生多项并发症,肝肾综合征是其中之一.一旦发展为肝肾综合征,治疗护理难度很大,病死率高.因此在改善肝功能的同时,预防肝肾综合征的发生尤为重要.近4年来,应用凯时注射液治疗慢性重症肝炎预防并发肝肾综合征,取得了较好的临床疗效.现介绍如下.
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重症肝病患者自杀心理障碍分析及疏导方法探讨
Background:Suicide is an much severe public hygiene problem. It was reported that suicidal rate in our country was 22.2 per hundred thousand each year(1993).One third of which was caused by their own diseases.Patients of severe hepatitis B suffer severe conditions of the disease with protracted course. It is easy for the patients to have severe psychonosema and suicide occurs.If the abnormal mood of the patients could be found early, the suicide might be avoided,and the patient might get rehabilitation earlier. Objective:To analyze the suicidal causes of the patients of hepatitis B and to study the method of treatment or persuation. Unit:Dept.of Hepatitis,the Sixth People's Hospital of Hangzhou Subjects:9 suicidal cases by falling from high place at the Dept. of Hepatitis B of the Sixth People's Hospital from 1991 to 2000 include 6 men and 3 women, with mean age of (36.7± 10.27) years(23～ 56 years) who were all diagnosed as chronic severe hepatitis with mean protracting course of (5.6± 4.2) years(2～ 11 years).The shortest inpatient time was 1 day,the longest was 228 days.7 of them were married.Their included 4 workers ,4 peasantsand individual trader.Their educational levels included 5 graduates from high school,4 from junior middle school.They all fell from the ward building for suicide. Intervention:The psychonosema were analysed by analyzing the patients'words,letters and their behavior before their suicides.Psychological therapy against these psychonosema were studied in order to avoid more suicide happen. Results:(1)Causes of suicides:One patient had symptoms of psychosis such as hallucination and delusional thinking disturbance.8 patients felt hopeless in curing the disease.4 cases had stress in family relationship. 3 cases could not endure body pain. 6 cases could not endure the heavy economic burden.Love relationship stopped because of the disease in 1 case.(2) Manifestations before their suicides 6 patients had insomnia, emotional lability,anxiety,pessimism and worldweariness in their words.They used to cry secretly.2 cases showed excessive care about their family with special exceted emotion.3 cases used to refered to psychological persuation.(3)Methods of psychological persuation:Physicians should have strong responsibility for their patients.They should understand patients' psychological state besides manage the primary diseases.Once psychological disorder occurred,psychological intervention should be administered immediately.If necessary,family members should participated the intervention.To let patients realize the impact of diseases.Physicians should help patients to clear anxiety and courage them to overcome the condition.Physicians should discuss the management project with patients.For patients with depression,monitoring should be focused.Consultation should be performed on severe patients.Environment surrounding patients should be improved.24-hour care should be carried out by family members. Conclusion:Delayed recovery of somatic diseases and drastic affliction will make patients loss the confidence,and hence exaggerate economical condition.Paradox within family will result severely psychological disorder and suicide.So,necessary psychological intervention is feasible.
