Study The Correlation Between Self-Care Ability And Prognosis After The First Aid On Patients With Upper Gastrointestinal Bleeding Caused By Liver Cirrhosis

Liver cirrhosis is a common chronic liver disease. Most of the patients with liver cirrhosis are the posthepatitic cirrhosis in China, a small part of patients are alcoholic cirrhosis and schistosomiasis cirrhosis. Cirrhosis patients with decompensation period often occur complications, for example upper gastrointestinal bleeding, hepatic encephalopathy, ascites, secondary infection, cancer. Especially, upper gastrointestinal bleeding is the most common, if not timely rescue, the mortality rate is high. The successful rescue of patients with major bleeding, the rebleeding rate is as high as 90% in 2 weeks. So taking active prevention intervention for rebleeding is very important. At present, domestic and foreign researchers start from nursing, research nursing intervention and health education mode on the patients with liver cirrhosis complicated with upper gastrointestinal bleeding. The results show that the effect of targeted health education can improve the self-care agency, and reduce the incidence of upper gastrointestinal bleeding. At present, the extent of the impact for health status of the patients is still no related research. The research analysis the relationship between self-care agency and the prognosis of patients with upper gastrointestinal bleeding, to indicate the importance of self-care agency in disease outcome, medical personnel pay attention to do health education for patients.Objective To investigate the self-care ability level and analysis the relationship between the self-care ability level and the prognosis of the patients with upper gastrointestinal bleeding caused by liver cirrhosis.Methods Selecting 78 cases of liver cirrhosis complicated with bleeding were into groups from 2012 July to 2014 July in our hospital. Be in hospital, using the questionnaire investigation way to know the general data of patients. The self-care agency scale(ESCA)was used to investigate the self-care ability and accord to the results into low, medium, high three levels. End 3 months follow-up period, to statistic the numbers of deaths and survivals of different levels patients, and calculate the model for end-stage liver disease (MELD-Na) score.Results1. Patients with upper digestive tract bleeding caused by hepatocirrhosis after the first aid, the self-care scored (84.07+17.38),76.6% patients were in the medium level.2. The self-care ability increased in conjunction with decreased mortality rate. The lower group mortality rate is 66.7%(8/12), which was significantly higher in each group with highest the self-care scored(all p<0.05).3. The three group scores of MELD-Na were respectively (38.29 ± 10.35,29.56±10.06,16.45±8.35).4. Likewise, complication incidence rates of hepatic encephalopathy, ascites, and hepatorenal syndrome increased when the self-care agency decreased.5. Using Pearson correlation analysis, the correlation between self-care agency and complication of cirrhosis patients indicated negative correlation(r=-0.387,-0.296,-0.140,P<0.05).Conclusions The self-care agency of patients with gastrointestinal bleeding caused by liver cirrhosisand is medium level. So we need to take effective measures to improve the patients’ self-care agency, to reduce complications and improve patient quality of life and prolong patient survival.