关键词: 慢加急性肝衰竭, 人工肝, 医护一体化管理模式, 传统管理模式

Abstract: Objective To evaluate the clinical effect of the new model of management model based on integration of medical and nursing (MM-IMN), and provide a basis for optimizing the management model of artificial liver treatment for patients with acute-on-chronic liver failure (ACLF). Methods Ninety-two patients with ACLF who received artificial liver treatment at Jinling Hospital Affiliated to Medical School of Nanjing University (General Hospital of the Eastern Theater Command), during the period from January 2022 to December 2024 were enrolled. The patients were randomly divided into the control group receiving traditional management model based mainly on nursing (MM-N group) and the intervention group receiving new management model based on integration of medical and nursing (MM-IMN group), with each group consisted of forty-six cases. The emotional experiences (anxiety, acceptance, compliance and satisfaction) and adverse reaction occurrence of the two groups were comparatively analyzed. Results The proportion of patients with higher levels of anxiety in the MM-IMN group (3rd and 4th levels accounting for 6.5% and 0.0% respectively) was significantly lower than that in the MM-N group (3rd and 4th levels accounting for 19.6% and 4.3% respectively), while the proportions of higher acceptance (82.6% and 56.5% respectively), higher compliance (80.4% and 63.0% respectively), and higher satisfaction (56.5% and 32.6% respectively) were all better than those of the MM-N group, all had a significant difference (P<0.05). The MM-IMN group achieved higher satisfaction scores in terms of the effectiveness of joint communication between medical/nursing staff and patients, clear explanation of treatment plans, timely detection and appropriate handling of adverse reactions. There was no significant difference in the incidence of adverse reactions between the two groups; however, a tendency was seen for the MM-IMN group to have a lower rate of adverse reactions than the MM-B group (4.3% vs. 13.0%, P=0.267). Conclusion The new management model based on integration of medical and nursing for artificial liver treatment is significantly superior to the traditional management model. It can more effectively alleviate the anxiety of patients with ACLF, enhance their acceptance, compliance and satisfaction, and help better prevent and treat adverse reactions related to artificial liver treatment. It is worthy of promotion and application.

Key words: Acute-on-chronic liver failure, Artificial liver treatment, Management model based on integration of medical and nursing, Traditional management model