论文部分内容阅读
目的通过对乙型肝炎病毒(HBV)携带者孕期抗病毒宫内阻断患者实施护理管理,提高患者治疗依从性和阻断成功率,保障母婴安全。方法选择2013年1月至12月在北京佑安医院分娩的HBV携带产妇692例为研究对象,妊娠28周。在充分告知风险利弊的前提下,根据患者意愿自愿选择进行孕期抗病毒宫内阻断治疗者318例为治疗组,不进行者374例为对照组。治疗组于妊娠28周开始口服替比夫定600 mg/d,至分娩后1个月停药,对照组不采取孕期阻断措施。两组孕妇所生婴儿出生后均接受乙肝疫苗和乙肝免疫球蛋白主被动联合免疫,完成联合免疫程序后于7、12月龄检测乙型肝炎病毒表面标志物(HBV-M)。护理人员同时对患者进行健康教育和咨询;配合医生指导治疗组患者详细阅读并签署知情同意书;将相关数据录入数据库,根据患者情况定期进行电话随访;分娩期加强陪护,规范做好新生儿保护及联合免疫。结果 HBV-M检测结果显示,婴儿出生后7月龄和12月龄HBs Ag阳性率治疗组(0.94%和0.31%)明显低于对照组(4.55%和4.01%),差异有统计学意义(P均<0.05)。治疗组和对照组婴儿出生缺陷率分别为1.89%(6/318)和2.14%(8/374),组间差异无统计学意义(P均>0.05)。患者依从性良好,无不良反应发生。结论做好HBV携带者孕期抗病毒宫内阻断患者的护理管理,有助于提高患者的依从性,使治疗安全、有效。
Objective To improve nursing compliance and blocking success rate of patients with HBV intrauterine antiviral intrauterine ablation during pregnancy to ensure the safety of mother and infant. Methods 692 cases of HBV-borne mothers who delivered at You’an Hospital in Beijing from January to December 2013 were selected as study subjects and were given 28 weeks’ gestation. In the full disclosure of the pros and cons of the premise of risk, according to the wishes of patients voluntarily choose intrauterine antiviral intrauterine block treatment of 318 patients for the treatment group, not carried out in 374 as the control group. The treatment group began oral telbivudine 600 mg / d at 28 weeks of gestation until 1 month after delivery, and the control group did not take the blocking measures during pregnancy. The babies born to pregnant women in both groups received primary and passive combined immunization of hepatitis B vaccine and hepatitis B immunoglobulin after birth. HBV-M was detected at 7 and 12 months after completion of the combined immunization program. Nursing staff at the same time for patients with health education and counseling; cooperate with the doctor to guide the treatment group patients read and sign informed consent in detail; the relevant data into the database, according to the patient’s regular telephone follow-up; strengthen the delivery during childbirth and regulate neonatal protection And combined immunization. Results The results of HBV-M test showed that the positive rates of HBsAg at 7 months and 12 months after birth in infants were significantly lower than those in control group (0.94% and 0.31%) (4.55% and 4.01%, respectively) P <0.05). The birth defects rate of the treatment group and the control group were 1.89% (6/318) and 2.14% (8/374), respectively. There was no significant difference between the two groups (P> 0.05). Patient compliance was good, no adverse reactions occurred. Conclusion The nursing management of patients with HBV intrauterine antiviral intrauterine blockade in HBV carriers during pregnancy helps to improve patient compliance and make the treatment safe and effective.