Early diet intervention to reduce the incidence of hepatic encephalopathy in cirrhosis patients: post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) findings.

Hepatic encephalopathy is a common complication in patients who have received transjugular intrahepatic portosystemic shunt (TIPS) as treatment for cirrhosis. The objective of this study was to reduce the incidence of post-TIPS hepatic encephalopathy for these patients via positive diet intervention.As a control group, 99 cirrhosis patients who underwent TIPS treatment in our department between August 2011 and February 2013 were chosen. Among these, postoperative hepatic encephalopathy occurred in 28 cases. After analyzing the possible causes and incentives of hepatic encephalopathy by applying retrospective analysis, it was seen that hepatic encephalopathy was caused mostly by improper diet (85.7%). The experimental group was comprised of 83 cirrhosis patients who underwent TIPS treatment during the period from May 2013 to September 2014. In view of the influence of improper diet, appropriate intervention measures were taken, including developing a postoperative nursing routine, training nurses about nutrition and the protein content of kinds of various common foods, customizing low-protein meals, training nurses in communication skills to improve the education of patients and establishing family support systems.For the experimental group, hepatic encephalopathy occurred in 10 patients, for an incidence of 12.1%, which is significantly lower than the control group (28.3%). This is a statistically significant difference (p<0.01) in the occurrence of this complication.After TIPS, early positive dietary intervention can significantly improve the compliance of cirrhosis patients to consume a low-protein diet and reduce the incidence of hepatic encephalopathy.背景与目的：肝性脑病是肝硬化患者经颈静脉肝内门体分流术（TIPS）术后 常见的并发症。本研究目的是通过积极的饮食干预降低TIPS 术后肝性脑病的 发病率。方法与研究设计：选择2011 年8 月至2013 年2 月的99 例接受TIPS 术治疗的肝硬化患者作为对照组。 其中，术后28 例并发肝性脑病。采用回顾 性研究分析肝性脑病发生的可能原因和诱因，饮食不当为主要诱因，占 85.7%。2013 年5 月至2014 年9 月的83 例肝硬化TIPS 术后患者作为实验 组，针对饮食不当这一主要问题采取相应的干预措施：制定TIPS 术后护理常 规，培训护士关于营养和常见食物中蛋白质含量的知识，定制低蛋白膳食，培 训护士沟通技巧以提高对患者的营养知识教育，帮助建立家庭-社会支持系 统。结果：实验组中有10 例发生肝性脑病，发病率为12.1%，与对照组 （28.3%）相比发病率显著降低（p<0.01）。结论：早期积极的饮食干预能显 著提高肝硬化患者TIPS 术后低蛋白饮食的依从性，降低肝性脑病的发生率。.