抗结核治疗致重症药物性肝炎的护理研究

目的 探讨抗结核治疗过程中致重症药物性肝炎的护理,以提高对肺结核的治疗及护理水平.方法 对医院2001-2011年735例肺结核住院经抗结核药物治疗后引起药物性肝炎的患者进行回顾性分析.结果 735例肺结核患者在经抗结核药物治疗期间,引起药物性肝炎的132例,总发生率为18.0％,其中重度20例、中度76例、轻度36例；在影响因素中,年龄＞55岁对肝损害的影响较大,25例中发生药物性肝炎20例,发生率达80.0％；吸烟的影响也较大,253例发生药物性肝炎75例,发生率为29.6％,差异有统计学意义(P＜0.05)；一线抗结核药物对不同年龄、不同体质肺结核患者有不同程度肝损害；轻者可继续抗痨治疗,重症则需减量或停用治疗药物并同时护肝治疗.结论 抗结核治疗期间,非常有必要密切观察病情、常规监测肝功能、及时发现肝损害、并认真做好用药安全护理.

Nursing of severe drug-induced hepatitis caused by anti-TB chemotherapy

OBJECTIVE To explore the nursing of severe drug-induced hepatitis caused by the anti-TB chemotherapy so as to improve the treatment and nursing of tuberculosis.METHODS A total of 735 patients with anti-TB drug-induced hepatitis,who enrolled the hospital from 2001 to 2011,were retrospectively analyzed.RESULTS During the period of chemotherapy for 735 tuberculosis patients with anti-TB drugs,the drug-induced hepatitis occurred in 132 cases with the incidence of 18.0%,including 20 cases of the severe,76 cases of the moderate,and 36 cases of the mild.Among the influencing factors,the age of more than 55 years could affect the liver damage most significantly,the drug-induced hepatitis occurred in 20 of 25 patients with the incidence reaching up to 80.0%;the smoking could also affect the liver damage to a certain extent,drug-induced hepatitis occurred in 75 of 253 patients with the incidence of 29.6%,the difference was statistically significant(P<0.05).The first-line anti-TB drugs could lead to the liver damage in varying degrees for the patients with various age and physical conditions;the mild patients could continue the anti-tuberculosis treatment,but the severe cases needed to reduce the dose or withdrawal with starting the liver protection treatment at the same time.CONCLUSION During the anti-TB chemotherapy,it is very necessary to observe the disease closely,monitor liver function routinely,detect the liver damage in a timely manner,and do a good job in safe mediation and nursing.