团队教育在血液透析患者矿物质和骨代谢紊乱管理中的应用  

Application of team-based health education in chronic kidney disease-mineral and bone disorder management of hemodialysis patients

作　　者：张晓宇[1] 朱金荣[1] 黄巍 鲁新红[1] 苏春燕[1] ZHANG Xiaoyu;ZHU Jinrong;HUANG Wei;LU Xinhong;SU Chunyan(Department of Nephrology,the Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院肾内科,北京市100191

出　　处：《护理管理杂志》2020年第3期225-228,共4页Journal of Nursing Administration

摘　　要：目的探讨团队合作式健康教育对血液透析患者慢性肾脏病矿物质和骨代谢紊乱的干预效果。方法选择血液透析中心的患者211例为研究对象,以护士为主导,在营养师和医生的协助下对患者进行饮食指导和治疗依从性指导。对比干预前后患者的血液透析充分性,血钙、磷甲状旁腺素水平以及用药(磷结合剂,骨化三醇)量的变化。结果干预后血磷显著降低(P<0.01),血甲状旁腺素水平明显改善(P<0.01),用药减少(P<0.01)。结论护士为主导,营养师和医生辅助的团队教育可以改善血液透析患者慢性肾脏病矿物质和骨代谢紊乱的各项临床指标。Objective To explore the effects of team-based education in chronic kidney disease-mineral and bone disorder(CKD-MBD)of hemodialysis patients.Methods A total of 211 patients in hemodialysis center were enrolled in the study.The nurse-led team including dieticians and doctors educated the hemodialysis patients on dietary modification and treatment compliance.Then the changes of the dialysis adequacy,blood calcium,blood phosphorus,blood parathyroid hormone levels and changes in medication(phosphorus binders,calcitriol)doses of the patients before and after intervention were compared.Results After intervention,the blood phosphorus level decreased significantly(P<0.01),parathyroid hormone levels were significantly improved(P<0.01),and medication doses decreased significantly(P<0.01).Conclusion The team-based education which nurse-led including dieticians and doctors can improve CKD-MBD related mineral and bone metabolism disorders in hemodialysis patients.

关 键 词：血液透析 慢性肾脏病 矿物质和骨代谢紊乱 健康教育 

分 类 号：R473.5[医药卫生—护理学] R318.16[医药卫生—临床医学]