Research progress on the quality of life and nursing intervention of patients with chronic liver disease complicated with pruritus
慢性肝病合并瘙痒患者的生活质量与护理干预研究进展

摘要

慢性肝病（chronic liver disease, CLD）是全球性的重大公共卫生问题，其病程长、并发症多，严重影响着患者的生存质量。皮肤瘙痒是慢性肝病最常见且令人痛苦的并发症之一，特别是胆汁淤积性肝病，如原发性胆汁性胆管炎（primary biliary cholangitis, PBC）和原发性硬化性胆管炎（primary sclerosing cholangitis, PSC）。肝病性瘙痒（cholestatic pruritus）机制复杂，严重程度不一，可从轻微不适到难以忍受的顽固性瘙痒，常导致患者睡眠剥夺、焦虑抑郁、注意力不集中，甚至出现自杀倾向，从而严重损害了患者的生活质量。本文旨在通过系统梳理相关文献，综述慢性肝病合并瘙痒的病理生理机制、对生活质量的多维度影响，并重点探讨当前行之有效的护理干预措施。文章将护理干预划分为非药物性护理干预（如皮肤护理、环境调节、心理支持、健康教育与赋能）和药物性治疗的护理配合与管理两大范畴，强调以患者为中心的、个体化的、全程化的护理模式在缓解患者痛苦、提升其生活质量中的核心价值。最后，本文对未来研究方向，如新型治疗手段的护理应用、数字化健康干预等进行了展望，以期为临床护理实践提供理论依据和实践指导。

Abstract

Chronic Liver Disease (CLD) is a major global public health issue. It has a long course and many complications, seriously affecting the quality of life of patients. Pruritus is one of the most common and painful complications of chronic liver diseases, especially in cholestatic liver diseases such as primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Cholestatic pruritus has a complex mechanism and varies in severity, ranging from mild discomfort to unbearable and stubborn itching. It often leads to sleep deprivation, anxiety and depression, inattention, and even suicidal tendencies in patients, thereby greatly damaging their quality of life. This article aims to systematically review relevant literature, summarize the pathophysiological mechanism of chronic liver disease complicated with pruritus, its multi-dimensional impact on quality of life, and focus on discussing the currently effective nursing intervention measures. The article divides nursing intervention into two major categories: non-pharmacological nursing intervention (such as skin care, environmental regulation, psychological support, health education and empowerment) and the nursing cooperation and management of pharmacological treatment. It emphasizes the core value of the patient-centered, individualized and full-process nursing model in alleviating patients' suffering and improving their quality of life. Finally, this paper looks forward to future research directions, such as the nursing application of new treatment methods and digital health intervention, with the aim of providing theoretical basis and practical guidance for clinical nursing practice.