Cirrhosis is a common chronic liver disease, which is a progressive and diffuse liver damage caused by one or more etiologies acting on the liver for a long time or repeatedly. Clinically, there is often multi-system involvement, with impaired liver function and portal hypertension as the main manifestations. Patients often have long disease duration, repeated hospitalization lasting for years or decades, and most of the time need home treatment. If patients and their families can master the health education and nursing knowledge of cirrhotic diseases, they can better carry out home care, ensure the continuity of treatment and care, and reduce the occurrence of complications in order to facilitate the early recovery of patients.
(I) Education for patients
1.Psychological guidance
Maintain a positive, optimistic and comfortable mood, do not be nervous, not to produce anxiety, depression, impatient psychology, encounter problems more and communicate with family, friends, doctors, cheer up the spirit, establish confidence to overcome the disease.
2.Life habits and behavior guidance
1, the compensated period can participate in lighter work, develop a regular lifestyle, combine work and rest, avoid overwork, ensure sufficient sleep can not only save physical exertion, but also help improve liver circulation, promote physical recovery, promote liver cell regeneration, etc.
2.The decompensated period should be bed rest, or semi-sitting position to reduce abdominal distension causing discomfort and reduce the cardiopulmonary load Live a regular life, pay attention to warmth and personal hygiene.
3.People with edema should pay attention to skin protection, dress generously and softly, take daily bath with warm water, do not scratch the itchy skin with hands, give anti-itch treatment to avoid skin breakage and infection.
4, a regular work and rest schedule, moderate exercise, do not rush, but gradually, not too strong at the beginning, according to physical fitness appropriate exercise, such as walking, playing taijiquan, qigong, taiji sword, etc., to not fatigue is appropriate. Long-term bed rest can lead to loss of appetite, constipation, increased abdominal distension, etc., moderate exercise is extremely important for physical and mental health.
5, keep the stool smooth, can be regulated by diet, if necessary, by taking lactulose oral solution and other drugs to keep the stool 2-3 times a day.
3.Dietary guidance
Eat high-calorie, high-protein (except for hepatic encephalopathy), high-vitamin, and easy-to-digest food.
1, rice and flour as the main food, eat high-quality protein such as fish, eggs, soy products.
2.Control the intake of fats and oils, not more than 20g per day.
3.Patients with ascites or swelling should control the intake of water and sodium according to the indicators of urine volume and weight. For salt-free diet, the daily salt intake should not exceed 0.5 g; for low-salt diet, the daily salt intake should not exceed 2 g. For cirrhotic ascites, the fluid intake should be limited, and 500 ml can be added according to the previous day’s urine volume.
(Foods high in sodium include salted meat, soy sauce, pickles, etc. containing more sodium MSG, which should be consumed sparingly; foods containing less sodium include cereals, eggplant, fruits, etc.; foods containing more potassium include fruits, hard dried fruits, potatoes, meat, etc.)
(Low salt diet, less than 2 g per day, use beer bottle cap as a measuring device, each bottle cap is 3 g.)
4.Avoid eating rough, hard, not easy to bite food, such as: fried pasta, hard fruits and melons; avoid swallowing chicken bones, fish spines, etc.
5.Avoid spicy condiments, alcohol or stimulating food.
6.When the blood ammonia is high, protein intake should be limited, you can choose vegetable protein, such as soybean products, because methionine, aromatic amino acids, etc. are high, while ammonia-producing amino acids are low.
7, daily consumption to ensure the intake of vitamins. Fresh vegetables and fruits are rich in vitamins, for example, tomatoes and oranges are rich in vitamin C.
4.Medication guidance
Symptomatic treatment is the main focus, and the application of drugs that are damaging to the liver is prohibited. When there is ascites or swelling, diuretics should be used correctly according to medical prescription, and attention should be paid to maintaining water-electrolyte balance, or albumin and plasma should be used according to medical prescription to increase plasma colloid osmotic pressure and reduce ascites or swelling.
(2) Education for family members
Family members should understand and care about the patient, observe carefully, detect changes in the condition early, and be alert to the prodromal symptoms of hepatic encephalopathy when the patient shows abnormalities in personality and behavior, and regularly supervise the patient’s outpatient follow-up. Eliminate various factors that are unfavorable to the individual and family, and help the patient to establish confidence in overcoming the disease.