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熊去氧胆酸联合LEARNS模式健康教育对行腹腔镜保胆取石术患者疗效的影响

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目的 分析熊去氧胆酸(UAC)联合聆听-建立-应用-提高-反馈教学-强化模式健康教育(HE-LEARNS)对腹腔镜保胆取石术患者疗效的影响。方法 分析2021年1月至2023年1月杭州市中医院行腹腔镜保胆取石术患者的临床资料,根据术后干预方案分为对照组(UAC联合常规教育)和试验组(UAC联合HE-LEARNS)。主要观察指标为12个月胆囊结石复发率。次要观察指标为胆固醇代谢指标[总胆固醇(TC)、甘油三酯(TG)]、胆囊相关指标(胆囊壁厚度和胆囊收缩率)、生活质量[消化病生存质量指数(GIQ-LI)评分]、用药依从性[Morisky药物治疗依从性量表(MMAS)评分]和肝肾功能指标[天冬氨酸氨基转氨酶(AST)、丙氨酸氨基转氨酶(ALT)、血清肌酐(Scr)、血尿素氮(BUN)]的变化情况。结果 研究共纳入119例患者,试验组50例,对照组69例。试验组12个月胆囊结石复发率低于对照组(P<0。05)。治疗2个月后,试验组TC、TG、胆囊壁厚度低于对照组,胆囊收缩率高于对照组(P<0。05),GIQ-LI评分和MMAS评分高于对照组(P<0。05);两组间AST、ALT、Scr和BUN差异无统计学意义(P>0。05)。结论 UAC联合HE-LEARNS对腹腔镜保胆取石术术后患者疗效显著,可提高生活质量及用药依从性,改善胆固醇代谢和胆囊结构功能,降低12个月结石复发率。
Effect of ursodeoxycholic acid capsules combined with health education based on LEARNS model on the efficacy of patients undergoing laparoscopic biliary lithotomy
Objective To explore the efficacy of ursodeoxycholic acid capsules (UAC) combined with health education based on listen-establish-establish-adopt-reinforce-name-strengthen model (HE-LEARNS) in patients undergoing laparoscopic biliary lithotomy.Methods Clinical data of patients after laparoscopic biliary lithotomy at Hangzhou Hospital of Traditional Chinese Medicine from January 2021 to January 2023 were analyzed.Patients were divided into a control group (UAC combined with routine education) and a experimental group (UAC combined with HE-LEARNS) based on postoperative intervention plans.The primary observation index was the 12-month gallstone recurrence rate.Secondary observation indices included cholesterol metabolism indicators[total cholesterol (TC) and triglyceride (TG)],gallbladder-related indicators (gallbladder wall thickness and gallbladder contraction rate),the quality of life[gastrointestinal quality of life index,(GIQ-LI) score],medication adherence[Morisky medication adherence scale (MMAS) score],and changes in liver and kidney function[aspartate aminotransferase (AST),alanine aminotransferase (ALT),serum creatinine (SCr),and blood urea nitrogen (BUN)].Results A total of 119 patients were included in the study,with 50 in the experimental group and 69 in the control group.The 12-month recurrence rate of gallbladder stones was lower in the experimental group than in the control group (P<0.05).After 2 months of treatment,TC,TG,gallbladder wall thickness were lower in the experimental group than in the control group,and gallbladder contraction rate was higher in the experimental group than in the control group (P<0.05),and GIQ-LI score and MMAS score of the experimental group were higher than those of the control group (P<0.05);the differences in AST,ALT,SCr and BUN between the two groups were not statistically significant (P>0.05) Conclusion UAC combined with HE-LEARNS is significantly effective in the treatment of patients after laparoscopic biliary lithotomy,which can improve the quality of life and medication compliance of patients,improve cholesterol metabolism,gallbladder structure and function,and reduce the recurrence rate of stones at 12 months.

Ursodeoxycholic acid capsulesHealth education based on LEARNS modelCholecystolithiasisLaparoscopyTriglyceride

毛淑珍、李晓文

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杭州市中医院普外科,杭州 310007

熊去氧胆酸 LEARNS模式健康教育 胆囊结石 腹腔镜 胆固醇

2024

中国药师
国家药品监督管理局高级研修学院,武汉医药(集团)股份有限公司

中国药师

CSTPCD
影响因子:0.944
ISSN:1008-049X
年,卷(期):2024.28(10)