分组管理模式对血液透析患者血管通路维护的影响  

Effect of group management mode on vascular access in hemodialysis patients

作　　者：萧远英[1] 李芸[1] 王立平[1] 陈美凤[1] 王兰[1] 

机构地区：[1]广东省深圳市人民医院血液净化室,广东深圳518001

出　　处：《护士进修杂志》2017年第9期784-787,共4页Journal of Nurses Training

基　　金：广东省深圳市科技研发资金基础研究项目(编号:JCYJ20150403102020230)

摘　　要：目的探讨分组管理模式对血液透析患者血管通路维护的影响。方法选取2016年1-6月在我院行血液透析治疗的患者124例,将患者随机分为观察组和对照组,每组62例,对照组给予常规干预,观察组在对照组的基础上给予分组管理干预模式,比较两组干预期间再循环发生、尿素清除指数(Kt/V)、尿素下降率(URR)、甲状腺旁激素(iPTH)和微球蛋白(β2-MG)以及并发症情况。结果观察组发生再循环比例为14.52%,明显低于对照组(P<0.05);观察组Kt/V和URR分别为(1.215±0.084)%和(74.21±8.91)%,均明显高于对照组(P<0.05);观察组iPTH和β2-MG分别为(184.28±19.29)pg/mL和(36.79±3.30)mg/L,均明显低于对照组(P<0.05);观察组血管通路并发症发生率为4.84%,明显低于对照组(P<0.05)。结论分组管理模式能有效改善血液透析患者的钙磷代谢紊乱,降低血管通路再循环,提高透析充分性,降低血管通路并发症,值得临床推广使用。Objective To study the effect of group management mode on vascular access in hemodialysis patients. Methods 124 patients with hemodialysis in our hospital from January 2015 to January 2016 were randomly divided in to observation group and control group, 62 cases in each group. Patients in control group was given conventional in- tervention, and patients in observation group was given the group management mode and conventional intervention. The intervention recirculation, urea clearance index （Kt/V）, urea reduction rate （URR）, parathyroid hormone （iPTH） and β2-microglobulin （β2-MG） and incidence of complications was measured and compared between the two groups. Results： The rate of recirculation in the observation group was 14.52 o/4o, which was significantly lower than that of the control group （P〈0.05） ; The observation group Kt/V and URR were （1. 215＋0. 084） and （74.21± 8.91）%, which was significantly higher than that of the control group （P〈0.05） ; The iPTH and β2-MG in obser vation group were （184.28±19.29） pg/mL and （36.79±3.30） mg/L, which was significantly lower than that of the control group （P〈0.05）. The incidence of complications in the observation group was 4.84%, which was sig- nificantly lower than that of the control group（P〈0.05）. Conclusion The group management model can effectively improve the disorder of calcium and phosphorus metabolism, improve dialysis adequacy and reduce vascular access complications for patients with hemodialysis. It was worthy of clinical application.

关 键 词：分组管理模式 血液透析 通路再循环 透析充分性 护理 

分 类 号：R473[医药卫生—护理学] R459.5[医药卫生—临床医学]