分层护理干预对血液透析相关低血压的影响  

Influence of hierarchical nursing on hemodialysis-induced hypotension

作　　者：殷淑青 

机构地区：[1]北京市丰台中西医结合医院肾内科,100072

出　　处：《中华现代护理杂志》2017年第12期1663-1665,共3页Chinese Journal of Modern Nursing

摘　　要：目的 观察分层护理干预在维持性血液透析患者中的应用效果,探讨其预防低血压的临床应用价值.方法 选择2015年7—12月40例维持性血液透析患者,2015年7—9月为干预前,收集患者的低血压发生情况,并根据分析结果对患者进行分级.2015年10—12月针对每位患者透析低血压的发生率高低及低血压的原因来分层干预,对其中的Ⅰ级高危患者实施家属参与的个体化强化教育.比较分层护理干预前后患者血液透析相关低血压发生情况.结果 40例患者干预前透析次数1440例次,共发生低血压321例次（22.3%）,干预后1440例次中低血压发生246例次（17.1%）,其中Ⅰ级由干预前13例减少为干预后的9例,差异有统计学意义（P＜0.001）.透析的脱水量由（3.02±0.78）L下降为（2.70±0.74）L,差异有统计学意义（t=4.327,P＜0.001）.结论 分层护理干预可以明显降低透析中低血压发生率.Objective To explore the effects of hierarchical education on hemodialysis-induced hypotension （DIH） management.Methods Forty maintenance hemodialysis patients were selected into this study. DIH information was collected and classified during the pre-intervention period from July to September in 2015. The participants were divided into three levels based on their incidence and reasons of DIH. Hierarchical education was implemented accordingly during the intervention period from October to December in 2015. Participants with the highest risk of DIH and their family members should receive intensive education individually. The incidence of DIH before and after the intervention was compared.Results The incidence of DIH decreased from 22.3% （321/1440 times of DIH） to 17.1% （246/1440 times of DIH） and the incidence in patients with the highest risk of DIH reduced from 13 to 9 cases （P〈0.001）. The ultrafiltration volume significantly was decreased after the intervention [（3.02±0.78） L vs （2.70 ±0.74） L;t=4.327,P〈0.001]. Conclusions The hierarchical education is effective in preventing the incidence of DIH in maintenance hemodialysis patients.

关 键 词：肾透析 低血压 分层护理 

分 类 号：R473.5[医药卫生—护理学]