微信随访对慢性乙型肝炎患者抗病毒治疗效果和生活质量的影响研究(1)
摘 要：目的 通过微信延续性护理提高抗病毒治疗的效果，探讨抗病毒治疗期间患者的生活质量。方法 136例在本院治疗好转，但仍需要抗病毒治疗的慢性乙型肝炎患者根据知情同意的原则加入抗病毒治疗的微信平台。通过1年的微信干预，比较出院时和1年后抗病毒治疗的效果和生活质量的状况。结果 经过1年的微信随访发现，患者的ALT、总胆红素、白蛋白、病毒复制情况较出院时有所好转(P<0.05)；患者生活质量在腹部症状、困乏、系统症状和活动能力方面较出院时有所改善(P<0.05)，但在情感、焦虑方面的改变较出院时，差异无统计学意义(P>0.05)。结论 微信随访可以保证治疗效果，可以部分改善患者的生活质量，其临床价值值得继续探讨。
关键词：延续性护理；微信；慢性乙型肝炎；生活质量
中图分类号：R473.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.057
文章编号：1006-1959(2018)10-0164-03
, http://www.100md.com
Effect of WeChat Follow-up on Antiviral Treatment and Quality of Life in Patients with Chronic Hepatitis B
LIN Xiao-lan，ZHENG Li-hua，CHEN Yuan-li，JIANG Shu-xian，ZHENG Zi-mei
(Department of Infectious Diseases，Third Affiliated Hospital，Sun Yat-sen University，Guangzhou 510630，Guangdong，China)
Abstract：Objective To improve the effectiveness of antiviral therapy through WeChat continuity of care and explore the quality of life of patients during antiviral therapy.Methods 136 patients with chronic hepatitis B who needed treatment in our hospital，but still need antiviral therapy，joined the anti-virus treatment WeChat platform according to the principle of informed consent.Through 1 year of WeChat intervention，compare the effect of antiviral treatment and quality of life after discharge from hospital and one year later. Results After one-year follow-up by WeChat，the patients'ALT，total bilirubin，albumin，and virus replication were better than those at the time of discharge(P<0.05).The quality of life in patients with abdominal symptoms，drowsiness，systemic symptoms and activity were improved compared with those at discharge(P<0.05)，but there was no significant difference in affective and anxiety changes compared with those at discharge(P>0.05).Conclusion WeChat follow-up can guarantee the effect of treatment and partly improve the quality of life of patients，and its clinical value is worth further discussion.
, 百拇医药
Key words：Continuous nursing；WeChat；Chronic hepatitis B；Quality of life
乙型肝炎病毒嚴重威胁着人类的健康。据世界卫生组织报道，全球约20亿人曾感染过HBV，其中3.5亿人为慢性HBV感染者，每年约有100万人死于HBV感染所致的肝衰竭、肝硬化和原发性肝细胞癌，2006年全国乙型肝炎流行病学调查表明，我国1～59岁一般人群HBsAg携带率为7.18%。据此推算，我国现有的慢性HBV感染者约9300万人，其中慢性乙型肝炎患者约2000万例[1]。抗病毒治疗是慢性乙型肝炎治疗的重要手段，规范化的抗病毒治疗及治疗过程中的监测和随访是抑制病毒复制，减轻肝脏炎症坏死和肝纤维化，及时发现病毒耐药的保障[2]。研究表明，由于对慢性乙肝抗病毒治疗认识不足而拒绝抗病毒治疗的人数最多，占54.9%，受非专业性医生的误导而拒绝的占15.9%，因经济原因拒绝治疗的占6.1%，提示加强慢性乙肝防治知识宣教，正确理解抗病毒治疗的重要意义，才能提高患者接受抗病毒治疗的积极性[3]。目前，延续性护理多采用电话随访为主，也有通过护士门诊和家庭访视等，但并未普及社区。电话随访模式由于其单向性，多由医务人员主导，患者被动接受询问，或由于患者较强的自我防范意识及导致随访率不高[4]。随着智能手机的普及和微信的广泛应用，为探讨抗病毒治疗期间患者的疗效和生活质量，我们通过微信平台，对患者出院以后进行为期1年的随访干预，取得了良好的效果，现报告如下。, 百拇医药(林晓岚 郑丽花 陈苑莉)
关键词：延续性护理；微信；慢性乙型肝炎；生活质量
中图分类号：R473.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.057
文章编号：1006-1959(2018)10-0164-03
, http://www.100md.com
Effect of WeChat Follow-up on Antiviral Treatment and Quality of Life in Patients with Chronic Hepatitis B
LIN Xiao-lan，ZHENG Li-hua，CHEN Yuan-li，JIANG Shu-xian，ZHENG Zi-mei
(Department of Infectious Diseases，Third Affiliated Hospital，Sun Yat-sen University，Guangzhou 510630，Guangdong，China)
Abstract：Objective To improve the effectiveness of antiviral therapy through WeChat continuity of care and explore the quality of life of patients during antiviral therapy.Methods 136 patients with chronic hepatitis B who needed treatment in our hospital，but still need antiviral therapy，joined the anti-virus treatment WeChat platform according to the principle of informed consent.Through 1 year of WeChat intervention，compare the effect of antiviral treatment and quality of life after discharge from hospital and one year later. Results After one-year follow-up by WeChat，the patients'ALT，total bilirubin，albumin，and virus replication were better than those at the time of discharge(P<0.05).The quality of life in patients with abdominal symptoms，drowsiness，systemic symptoms and activity were improved compared with those at discharge(P<0.05)，but there was no significant difference in affective and anxiety changes compared with those at discharge(P>0.05).Conclusion WeChat follow-up can guarantee the effect of treatment and partly improve the quality of life of patients，and its clinical value is worth further discussion.
, 百拇医药
Key words：Continuous nursing；WeChat；Chronic hepatitis B；Quality of life
乙型肝炎病毒嚴重威胁着人类的健康。据世界卫生组织报道，全球约20亿人曾感染过HBV，其中3.5亿人为慢性HBV感染者，每年约有100万人死于HBV感染所致的肝衰竭、肝硬化和原发性肝细胞癌，2006年全国乙型肝炎流行病学调查表明，我国1～59岁一般人群HBsAg携带率为7.18%。据此推算，我国现有的慢性HBV感染者约9300万人，其中慢性乙型肝炎患者约2000万例[1]。抗病毒治疗是慢性乙型肝炎治疗的重要手段，规范化的抗病毒治疗及治疗过程中的监测和随访是抑制病毒复制，减轻肝脏炎症坏死和肝纤维化，及时发现病毒耐药的保障[2]。研究表明，由于对慢性乙肝抗病毒治疗认识不足而拒绝抗病毒治疗的人数最多，占54.9%，受非专业性医生的误导而拒绝的占15.9%，因经济原因拒绝治疗的占6.1%，提示加强慢性乙肝防治知识宣教，正确理解抗病毒治疗的重要意义，才能提高患者接受抗病毒治疗的积极性[3]。目前，延续性护理多采用电话随访为主，也有通过护士门诊和家庭访视等，但并未普及社区。电话随访模式由于其单向性，多由医务人员主导，患者被动接受询问，或由于患者较强的自我防范意识及导致随访率不高[4]。随着智能手机的普及和微信的广泛应用，为探讨抗病毒治疗期间患者的疗效和生活质量，我们通过微信平台，对患者出院以后进行为期1年的随访干预，取得了良好的效果，现报告如下。, 百拇医药(林晓岚 郑丽花 陈苑莉)