纽曼系统模式在肝硬化失代偿期患者护理中的应用

目的研究纽曼系统模式用于肝硬化失代偿期患者的护理效果。方法将肝硬化失代偿期患者150例，按照随机数字表分成观察组和对照组各75例，对照组依照临床分级护理内容标准及患者自理能力评估量表进行护理，观察组在此基础上根据患者机体内外因素、人际因素等方面存在的压力源对机体弹性防线、正常防线、抵抗防线的影响，应用纽曼系统模式进行一、二、三级预防措施干预，两组均于人院时及出院后随访1年，采用汉密尔顿抑郁量表（HRSD）、简明健康状况问卷（SF-36）中文版进行测评，比较两组患者抑郁症状、生存质量、住院时间、随访1年再住院率及病死率。结果观察组干预后HRSD评分、SF-36评分、住院时间分别为（33．4±4．1）分，（74．6±4．5）分，（10．2±3．5）d，优于对照组的（46．3±5．2）分，（56．1±5．1）分，（14．3±4．5）d，两组比较差异有统计学意义（t分别为11．40，9．30，1．41；P〈0．05）；观察组患者随访1年再住院率、病死率分别为24％，10％，明显低于对照组的53％，24％，两组比较差异有统计学意义（x2分别为2．1，3．4；P〈0．01）。结论纽曼系统模式用于肝硬化患者的护理有较好的效果，该模式可在临床进一步推广和应用。

Application of Neuman systems model in the nursing of patients with decompensated Hver cirrhosis

Objective To study the nursing effect of Neuman systems model in patients with decompensated liver cirrhosis. Methods One hundred and fifty patients with decompensated liver cirrhosis were randomly divided into the observation group and the control group according to random number table, each with 75 cases. The control group received the nursing according to the standards of clinical grading nursing content and the patient self-care ability assessment scale, and the observation group received one, two and three grade prevention intervention through the application of Neuman systems model according to the effect of pressure source existing in inside and outside of body as well as interpersonal relationship on body＇ s elastic line, formal line and resistance line on the basis of control group. The depressive symptom, the quality of living, the hospitalizing time, the rate of re-hospitalizing and the mortality rate were evaluated by Hamilton Depression Rating Scale for Depression （HRSD） and the Short Form-36 Health Survey （SF-36） Chinese version in two groups in the admission and 1 year follow-up after discharge. Results The scores of HRSD and the quality of living, the hospitalizing time were respectively （ 33.4 ± 4. 1 ）, （74. 6 ± 4.5 ）, （ 10. 2 ±3.5 ） d in the observation group, and were better than （46.3 ± 5.2）, （56.1 ± 5.1 ）, （ 14.3 ± 4.5 ） d in the control group, and the differences were statistically significant （t = 11.40, 9.30, 1.41, respectively ; P 〈 0.05）. The rate of re-hospitalizing and the mortality rate were 24% , 10% in the observation group, and were significantly lower than 53%, 24% in the control group, and the differences were statistically significant （X2 = 2. 1, 3.4, respectively ; P 〈 0.01 ）. Conclusions The application of Neuman systems model in the nursing of patients with decompensated liver cirrhosis has a relatively good effect, and the model should be further promotion and application in clinical.