Application of diet care based on PHES in post-TIPS management

doi:10.3877/cma.j.issn.2095-5782.2021.02.020

Abstract

Abstract:

Objective

To investigate the application value of dietary nursing strategies based on psychometric hepatic encephalopathy score (PHES) in postoperative management of patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS).

Method

From March 2018 to January 2020, the patients with liver cirrhosis treated with TIPS were randomly divided into experimental group and control group. Patients in experimental group were given individualized diet nursing based on PHES after TIPS operation, while patients in control group were given standard diet nursing after TIPS operation. Statistical analysis of the difference in the incidence of various types of hepatic encephalopathy was statistically analyzed between the two groups during postoperative follow-up. The follow-up time was 13 (6~28) months.

Results

This study included 160 patients, within 6 months after TIPS, the incidence rates of HE and mild HE in the experimental group (26.25% and 15.00%) were lower than those in the control group (47.50% and 28.75%). There was no significant difference in the incidence of severe HE between the two groups (11.25% and 18.75%). The incidence of induced HE in the experimental group was lower than that in the control group (10.00% and 27.50%).There was no significant difference in the incidence of non-induced HE between the two groups (16.25% and 20.00%).

Conclusions

Dietary and nursing strategies based on PHES score can reduce the incidence of induced and mild HE in patients with cirrhosis after TIPS, thus reducing the incidence of overall HE in patients after TIPS and improving their quality of life.

Key words: Transjugular intrahepatic portosystemic shunt, Psychometric hepatic encephalopathy score, Hepatic encephalopathy, Diet nursing

Yonghui Zhang, Li Dong, Cuixia Wang, Delei Cheng, Chunze Zhou, Weifu Lv. Application of diet care based on PHES in post-TIPS management[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(02): 224-228.

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References 17

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		实验组（n = 80）	对照组（n = 80）	χ²/t值	P值
年龄（岁）		53.7 ± 11.1	53.6 ± 10.2	0.082	0.935
性别				2.209	0.137
	男	65/81.25%	57/71.25%
	女	15/18.75%	23/28.75%
门静脉高压症状				1.671	0.434
	上消化道出血	30/37.50%	26/32.50%
	腹水	19/23.75%	15/18.75%
	两者均有	31/38.75%	39/48.75%
病因				2.375	0.667
	乙肝	55/68.75%	48/60.00%
	丙肝	3/3.75%	3/3.75%
	酒精性	5/6.25%	10/12.50%
	胆汁淤积性	2/2.50%	3/3.75%
	其他	15/18.75%	16/20.00%
体重指数		21.01±2.87	21.08±2.80	0.041	0.888

		实验组（n = 80）	对照组（n = 80）	χ²/t值	P值
年龄（岁）		53.7 ± 11.1	53.6 ± 10.2	0.082	0.935
性别				2.209	0.137
	男	65/81.25%	57/71.25%
	女	15/18.75%	23/28.75%
门静脉高压症状				1.671	0.434
	上消化道出血	30/37.50%	26/32.50%
	腹水	19/23.75%	15/18.75%
	两者均有	31/38.75%	39/48.75%
病因				2.375	0.667
	乙肝	55/68.75%	48/60.00%
	丙肝	3/3.75%	3/3.75%
	酒精性	5/6.25%	10/12.50%
	胆汁淤积性	2/2.50%	3/3.75%
	其他	15/18.75%	16/20.00%
体重指数		21.01±2.87	21.08±2.80	0.041	0.888

	总体（n = 160）	实验组（n = 80）	对照组（n = 80）	t值	P值
白细胞（×10⁹/L）	3.94 ± 2.71	3.65 ± 2.81	4.23 ± 2.60	1.366	0.174
红细胞（×10¹²/L）	2.84 ± 0.64	2.87 ± 0.60	2.80 ± 0.70	0.704	0.482
血红蛋白（g/L）	78.79 ± 20.66	79.54 ± 19.27	78.05 ± 22.07	0.454	0.650
血小板（×10⁹/L）	86.97 ± 72.61	86.54 ± 79.40	87.41 ± 65.63	0.076	0.940
AST（IU/L）	35.98 ± 25.21	35.31 ± 19.41	36.66 ± 30.04	0.336	0.738
ALT（IU/L）	27.18 ± 19.10	28.61 ± 20.83	25.75 ± 17.21	0.946	0.345
总胆红素（μmol/L）	22.27 ± 12.67	23.16 ± 14.14	21.38 ± 11.03	0.883	0.378
白蛋白（g/L）	33.56 ± 5.41	32.92 ± 5.23	34.20 ± 5.55	1.504	0.135
肌酐（μmol/L）	68.21 ± 22.37	70.09 ± 25.29	66.34 ± 18.99	1.061	0.291
凝血酶原时间（s）	17.31 ± 3.62	17.61 ± 4.02	17.02 ± 3.17	1.033	0.303
血氨（μmol/L）	41.23 ± 26.77	38.02 ± 24.33	44.46 ± 28.79	1.527	0.129
PHES评分（分）	-4.89 ± 3.51	-4.77 ± 3.55	-5.01 ± 3.48	0.427	0.670
Child评分（分）	7.38 ± 1.56	7.36 ± 1.75	7.39 ± 1.35	0.101	0.920

	总体（n = 160）	实验组（n = 80）	对照组（n = 80）	t值	P值
白细胞（×10⁹/L）	3.94 ± 2.71	3.65 ± 2.81	4.23 ± 2.60	1.366	0.174
红细胞（×10¹²/L）	2.84 ± 0.64	2.87 ± 0.60	2.80 ± 0.70	0.704	0.482
血红蛋白（g/L）	78.79 ± 20.66	79.54 ± 19.27	78.05 ± 22.07	0.454	0.650
血小板（×10⁹/L）	86.97 ± 72.61	86.54 ± 79.40	87.41 ± 65.63	0.076	0.940
AST（IU/L）	35.98 ± 25.21	35.31 ± 19.41	36.66 ± 30.04	0.336	0.738
ALT（IU/L）	27.18 ± 19.10	28.61 ± 20.83	25.75 ± 17.21	0.946	0.345
总胆红素（μmol/L）	22.27 ± 12.67	23.16 ± 14.14	21.38 ± 11.03	0.883	0.378
白蛋白（g/L）	33.56 ± 5.41	32.92 ± 5.23	34.20 ± 5.55	1.504	0.135
肌酐（μmol/L）	68.21 ± 22.37	70.09 ± 25.29	66.34 ± 18.99	1.061	0.291
凝血酶原时间（s）	17.31 ± 3.62	17.61 ± 4.02	17.02 ± 3.17	1.033	0.303
血氨（μmol/L）	41.23 ± 26.77	38.02 ± 24.33	44.46 ± 28.79	1.527	0.129
PHES评分（分）	-4.89 ± 3.51	-4.77 ± 3.55	-5.01 ± 3.48	0.427	0.670
Child评分（分）	7.38 ± 1.56	7.36 ± 1.75	7.39 ± 1.35	0.101	0.920

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