Among the five common types of liver diseases, hepatitis B is the most harmful and widespread. China is a big country with liver diseases, especially hepatitis B (HBL) virus is infected by about 1.3% of the population in China. For patients with liver disease, affection, marriage, enrollment, employment, going abroad and socializing are all restricted to varying degrees and even discriminated against. It inevitably casts a layer of sadness on life. Life is very important to everyone, especially to this group of vulnerable groups. They are at a loss about treatment and health, and seek medical advice everywhere. What new methods are there from space to the earth, and they all end in helplessness and loss, and widely agree with the theory that there is no cure for hepatitis B. Because of this, I lost the confidence of treatment, that is, many patients lost the opportunity of treatment, but the victims were all patients. Due to long-term untreated, busy work and great psychological pressure, the virus continued to develop, delaying the treatment time and developing into cirrhosis, ascites and liver cancer. The situation is getting more and more serious, and it is urgent.
In recent years, viral hepatitis, hepatic fibrosis, fatty liver, alcoholic hepatitis, drug-induced liver injury, liver cirrhosis, liver cancer and other liver diseases are one of the main diseases that threaten human health in today's society. According to the latest statistics, there are more than 14% of people infected with viral hepatitis and hepatitis B virus carriers in China. It is precisely because these two kinds of viral hepatitis carriers have different degrees of love and even discrimination for family, love, enrollment, employment, going abroad and socializing. Because of this, the patient was rushed to the hospital, which not only failed to get the best treatment effect, but also delayed the treatment time, which aggravated the condition and developed into liver fibrosis, liver ascites, liver peritoneum and liver cancer. I agree with the saying that there is no cure for hepatitis B, because this sentence makes patients with viral hepatitis B lose confidence in treatment, and makes the virus replicate repeatedly in the body, resulting in lesions. This is also the cause of liver fibrosis, cirrhosis and liver cancer. As a result, more than one million people die of liver cirrhosis and liver cancer every year.
Pay more attention to self-care in autumn and winter to prevent the recurrence or occurrence of chronic hepatitis. What should be done in this regard?
The manifestations of chronic hepatitis are varied, and the treatment methods are also varied. But the principle of treatment is the same, that is, proper rest and nutrition are the mainstay, supplemented by drug treatment. Attention should be paid to the following aspects of self-care:
First, we should pay attention to the harmfulness when jaundice deepens. Once jaundice occurs in patients with hepatitis, it means that there is obvious inflammation in the liver and even hepatocyte necrosis. The more obvious the necrosis of liver cells, the deeper the jaundice will be. Therefore, when patients with hepatitis have deep jaundice, we should be alert to the possibility of severe hepatitis caused by large-scale hepatocyte necrosis. As far as the current treatment level is concerned, the early treatment of severe hepatitis is more effective; The medium-term treatment effect is poor, and the cure and improvement rate is only about 50%; In the late stage, the chance of rescue treatment is lost, and its mortality rate is as high as 90%. Therefore, when hepatitis patients have jaundice, they should stay in bed in time and go to the hospital as soon as possible.
Second, avoid alcohol. Because alcohol not only directly damages the liver, but also aggravates the disease and affects the therapeutic effect of antiviral drugs.
Third, rest and nutrition should be moderate. Excessive rest and nutrition will lead to overnutrition, fatty liver and other related diseases, while doing nothing will aggravate psychological stress and produce neurasthenia. So in the case of normal liver function, you can study and live normally.
Fourth, it is forbidden to use more drugs and abuse drugs. Patients with asymptomatic chronic hepatitis generally do not need medication. Some patients always think that they must take medicine if they are sick, and they will feel safe after taking medicine. In fact, most patients with hepatitis B and C don't need to take medicine. Improper medication is not only unsafe, but also often causes drug-induced hepatitis or other related adverse drug reactions.
Fifth, drug addicts can't fish for two days and dry the net for three days. Patients with hepatitis should follow the doctor's advice and insist on taking medicine on time when receiving medication. If you don't take the medicine on time, it will affect the curative effect and increase the adverse reactions of the medicine. Antiviral drugs are also prone to drug resistance.
Sixth, we should establish confidence and fully understand the long-term treatment of chronic hepatitis. Whether it is chronic hepatitis B or chronic hepatitis C, the treatment time, especially the treatment time of antiviral drugs, is generally longer. For chronic hepatitis B, long-term treatment is needed. For patients with poor or late curative effect, we should establish confidence and insist on taking medicine, and their condition will get better day by day.
What are the manifestations and clinical significance of the five indicators of hepatitis B?
Introduce the knowledge about hepatitis B: In the late 1950s, Baruch Blumber began to collect blood samples from all over the world in order to study the blood protein components with genetic variation. After several years' efforts, he finally determined that the antigen substance first found in Australian aborigines' blood was HbsAg. Since then, more studies have found anti-HBs ((hepatitis B virus surface antibody) HBeAg (hepatitis B virus E antigen) anti-HBe (hepatitis B virus E antibody) anti-HBc (hepatitis B virus core antibody).
It means in bed
( 1) (2) (3) (4) (5)
HBsAg anti-HBs HBeAg anti-HBe anti-HBc
1,-There was no HBV infection in the past and now.
2.-+ Once infected with HBV, recover from acute infection.
3.-++HBV has been infected in the past and now.
4.-+- Vaccination prevention; Or HBV infection has been cured.
5,-+-++previous infection; Recovery period of acute HBV infection
6.-+-+ Past infection; Acute HBV infection has been cured.
7.+++ acute HBV infection; Chronic HBsAg carrier
8.+++ Acute HBV infection tends to recover; Chronic HBsAg carriers are weakly contagious; Long-term persistent canceration
9.++-Acute or chronic hepatitis B is highly contagious.
10, +-HBsAg carriers in the early stage of acute HBV infection
1 1,+-+-Acute HBV infection occurs early and is highly contagious.
12,-++intermediate acute infection
13,+-++acute infection tends to recover; Chronic carrier
14,+-+-Acute infection tends to recover.
15,-+-Acute infection tends to recover.
HBV infection has recovered.
Attachment: How does hepatitis B recover nutritionally?
Gan Bao Weiyang Powder, a liver-protecting nutrient developed by experts from the Key Laboratory of Trace Element Nutrition of the Ministry of Health, has been affirmed by more and more patients with liver diseases, and the era of nutritional rehabilitation of liver diseases is coming quietly like diabetes. For hepatitis B virus carriers, chronic hepatitis, cirrhosis, liver cancer and fatty liver, please continue reading the following and refer to the recommended liver-nourishing surgery.
As we all know, in the past, many diabetic patients just wanted to be cured quickly and used a lot of drugs, which led to premature death of complications. Later, people finally found that to deal with chronic diseases, we must pay great attention to nutrition. Results Many diabetic patients lived to be eighty or ninety years old after reasonable nutrition. So, can nutritional rehabilitation of chronic liver disease be done?
Liver disease is a chronic disease, which has a wide range of patients in China. There is no specific medicine in the market, and traditional medicine cannot be completely cured. For a long time, the majority of friends with liver diseases have suffered both psychological and physical torture. Nourishing liver gives us a good answer.
Common psychology and nursing care of patients with hepatitis B.
First, depression
Depression is a gloomy and depressed negative emotion, which is mainly caused by the loss of reality or expectation. Because illness is an unpleasant thing for anyone, and it is accompanied by a sense of loss, most patients will have different degrees of depression. However, the patient's depression is manifested in various aspects. For example, some pose and try to cover up; There are very few words, and they are not interested in anything outside; Some people are sobbing or crying; Others give up on themselves, give up treatment, and even have suicidal thoughts.
Severe depression often leads to helplessness and despair. This is an emotional state of helplessness, grief and self-pity, which mostly occurs in patients with poor prognosis or life-threatening. Seligman believes that when a person loses control of the situation and knows that he can't change it, he will feel helpless and desperate. Most of this emotional state is unstable, so it will disappear as long as the condition improves slightly or the external environment improves slightly. However, this emotional state can last for a few people, directly affecting the treatment of diseases, and some can also induce secondary diseases.
Second, anxiety.
Anyone's life will inevitably be anxious for some reason. The patient's illness, of course, can not avoid anxiety. Anxiety is the fear and depression that a person feels threatened. This kind of threat is mainly divided into two categories: one is that the integrity of the body is threatened, and the other is that the personality is threatened. The physical and psychological threats to patients are often unified and will last until patients are safe and stable again.
There are many factors that cause patients' anxiety. For example, the uncertainty of the etiology and prognosis, especially the prognosis, in the early stage of the disease will lead to anxiety unrelated to the disease, or excessive attention to the etiology, prognosis and prognosis. At this time, if doctors and nurses do not explain clearly to patients in time, there will be a tendency to exaggerate the severity of the disease. As Fletcher said: "Not commenting is not a good thing, it will induce the fear of patients. "Some patients' examination and treatment are physically threatening, and diseases with poor prognosis, such as cancer, can cause intense anxiety. For example, a patient who is preparing for surgery is looking forward to the operation as soon as possible after admission. Once he is told that he will have an operation tomorrow, he will become anxious and panic. In the investigation of hospitalized patients, it is found that most patients have anxiety reaction when they are admitted to hospital. When they see the situation of critically ill patients, hear the introduction of their own patients, and see doctors and nurses rushing back and forth to rescue critically ill patients, they can't help but feel an unusual sense of terror, as if they are also facing great threats, resulting in anxiety. They want to investigate the disease in depth, but they are afraid of the terrible consequences; They repeatedly asked about their illness, but they were dubious about the diagnosis, worried and anxious. In short, the patient's illness is an unpleasant emotional stimulus, which is easy to form bad emotions. If you are in a bad mood, everything will be unsatisfactory and you will always be upset. Based on this state of mind, you are prone to anxiety or depression. In men, it is often noisy for a little thing, while in women, it is mostly depression and crying. Especially when the condition changes, or when you have a special examination, or are ready for surgery, you will feel more irritable, sleep badly, eat badly, get angry easily, and even be willful. Some people will have some abnormal behaviors, such as some people suddenly freshen up, get a haircut and shave, some people write a lot of letters, some people gobble up, some people look out of the window for a long time, and some people fall asleep.
It is not easy to completely eliminate the anxiety of patients, and mild anxiety is conducive to the treatment of diseases. But for patients with extreme anxiety and long-term anxiety, doctors and nurses should pay special attention to help them reduce their psychological burden as much as possible, so as not to hinder the treatment of diseases and induce other diseases.
Third, doubt.
The patient's suspicion is mostly a hint of self-denial, which often affects the correct judgment of objective things because of lack of evidence. After illness, I often become extremely sensitive. When I heard someone whispering, I thought I was saying that my illness was serious or incurable. Advise others with a grain of salt, and even misinterpret the original intention. Doubt, fear of misdiagnosis, fear of taking the wrong medicine, wrong needle. Some people infer drugs and prognosis based on their little knowledge of medicine and pharmacology. Afraid of the side effects of drugs. Worried about occasional medical mistakes or unexpected misfortunes. If you feel that some part of your body is a little abnormal, you will make a guess. If you are seriously paranoid, you may even have irrational delusions.
Some patients have a low education level and lack scientific knowledge of physiology and pharmacology, so they often use feudal superstition to understand the abnormal phenomena of their physiological functions. When the course of the disease is inconsistent with his own expectations, he will fall into confusion and even live in fear.
Medical staff need to find patients' doubts in conversations with patients or from patients' feedback and try to solve them. When giving drugs and injections, we must show a rigorous attitude in front of patients in order to gain their trust. Talk between medical staff in front of patients, be as generous and natural as possible, and reduce patients' suspicion. More importantly, we should patiently explain to those patients who have little knowledge of medicine, and advise relatives and friends who don't understand medicine not to explain in front of patients.
Fourth, loneliness
After the patient was hospitalized, he left his family and work unit and was surrounded by strangers. Doctors only talk to patients once a day during rounds, and nurses take injections and medicines regularly, so there are fewer opportunities to talk. In this way, patients are prone to loneliness. Therefore, their first day in the ward often feels like a year. They hope to get familiar with the environment and patients as soon as possible, and they also hope to be accompanied by relatives and friends. Patients who have been hospitalized for a long time are bored and bored. I hope that patients can have more conversations and appropriate cultural and recreational activities to enliven ward life.
Some patients are restless at night, some get up and pace, and some repeatedly press the signal light to say a few words to the staff on duty. Medical staff should understand the patient's lonely mood, patiently comfort the patient and let him sleep quietly.
The deprivation of social information and the unsatisfied need for attachment to relatives are the main reasons for patients' loneliness. Therefore, if the equipment and management level allow, relatives and friends should be allowed to visit frequently or accompany them around the clock.
Verb (abbreviation for verb) passive dependence
After patients enter the role of patients, most of them will have a psychological state of passive dependence. This is because once a person is sick, he will naturally be taken care of by his family and comrades around him. Even members with low status at home or at work have suddenly become the center of care. At the same time, through self-suggestion, patients themselves become soft and not as lively as before, passive, obedient, angry, dependent, emotionally fragile and even a little childish. As long as there are relatives present, let others do what they could have done; I could have eaten it, but I couldn't eat it after several persuasion; People who have always had strong independence will become independent; People who have always been conceited and competitive become unconfident; Even people who are used to leadership and dominance are now obedient to medical staff. At this time, their love and sense of belonging are enhanced, and they hope to get more visits from relatives and friends, and hope to get more care and warmth, otherwise they will feel lonely and self-pity.
Strong will is one of the important factors for patients to overcome diseases. On the one hand, medical staff should make patients feel that hospitals and medical workers can be trusted, on the other hand, they should also help patients improve their subjective initiative to overcome diseases. Otherwise, once they feel that they have lost sympathy and have not received enough care, they will become depressed and even aggravate their illness.
At present, the new nursing theory holds that the patient's passive dependence after illness is unfavorable to the disease, so the theory of "health self-control" is put forward, which advocates giving full play to the patient's positive initiative in the course of the disease. They think that hospitals like patients to do things according to doctor's advice, and that this is a good patient, while those who insist on "self-care rights" are often criticized. In fact, the latter recovers faster and has better effect than the former. Therefore, they advocate that patients should not be tolerated, but should be encouraged to take care of themselves.
Step 6 deny it
Clinically, we can also see that some patients doubt or deny that they are sick. Especially for diseases with poor prognosis such as cancer, denial is more common. For example, a chief physician knows that she has cancer, but denies it. She saw the diagnosis written in the medical record and said that the doctor had written it wrong. Some medical staff feel incredible about this phenomenon. In fact, this is a self-defense way for some patients to deal with dangerous situations. A large number of studies have proved that a certain degree of denial is desirable to relieve psychological pressure. Denial is like the pupil's reflection of light. Once stimulated by strong external light, the pupil will automatically contract to prevent the retina from being over-stimulated. The patient's denial has a similar effect. When an unbearable bad situation strikes, self-denial can avoid excessive anxiety and fear. Patients with severe burns, acute polio and cancer are easy to deny. In a study of patients with coronary heart disease, it was found that people with obvious denial reaction had lower mortality than those without denial reaction.
Although denial has played a role in self-protection to a certain extent, it has also played a negative role in delaying the illness in many cases. For example, a young woman has lung cancer, but she denies it and refuses treatment. Died of brain metastasis six months later. Some people have investigated female patients with breast cancer and found that most of them are people who have a tendency to deny diagnosis and treatment.
Seven, sympathy
Everyone has compassion, compassion and affinity. A foreign psychologist made an interesting experiment with female college students as subjects, and found that the more people in danger, the stronger their affinity with people with destiny. The experimental results can also be verified in patients. Medical staff can see that once patients live together, they can get to know and understand each other soon. They are easy to unite, and most of this unity does not pay attention to the level of position, age and so on. As long as they are patients, they can treat each other as equals and talk about everything. They are concerned about the changes of patients' condition and are willing to introduce their painful symptoms to medical staff and help them overcome difficulties. For example, an old professor who was over 60 years old was admitted to a ward with seven patients because of coronary heart disease. Among them are workers, farmers and cadres. The oldest is 74 years old and the youngest is only 2 1 year old. They soon established a deep friendship. Every time patients leave the hospital, they say goodbye, tell each other, comfort each other, leave their addresses, and hope to keep in touch forever. This kind of mutual pity and affinity between patients and friends can alleviate everyone's loneliness, enhance their sense of security, and also help to enliven the air in the ward and adjust the mood of patients, which is undoubtedly beneficial to the treatment of diseases. However, this kind of misery loves company sometimes has a negative effect. For example, when a patient's condition deteriorates, the whole ward immediately becomes lifeless and terrible, and everyone's mind is covered with a dark cloud. Once some patients die because of ineffective rescue, it will be even more horrible and sad. In addition, negative hints between patients and friends often have adverse effects, such as introducing folk remedies and so-called experiences to each other and interfering with doctors' correct treatment.
Eight, by luck
Most patients have different degrees of luck. For example, in the early stage of the disease, many people are reluctant to enter the role of patients, hoping that the doctor's diagnosis is wrong. Especially those who are not sensitive to diseases, their luck is particularly serious. Some people who have been diagnosed. There is often a sense of luck. There are two situations. First, the diagnosis of their own diseases is still dubious, so sometimes they don't follow the doctor's advice; Second, people who lack medical knowledge and scientific attitude say, "Don't listen to the doctor's threats, God may not have a hard time with me". In fact, patients often delay their illness, leading to adverse consequences. Therefore, medical staff should carefully explain and patiently persuade patients according to their specific psychology, and try their best to make patients establish a scientific attitude towards diseases and overcome their fluky psychology.