医院社区一体化管理对慢性肾脏病患者疾病干预的影响分析  

Influence of hospital community integrated management on chronic kidney disease patients

作　　者：张华[1] 罗燕[1] 李雪芹[1] 马登艳[1] 刁永书[1] Zhang Hua;Luo Yan;Li Xueqin;Ma Dengyan;Diao Yongshu(Department of Nephrology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院肾脏内科,成都610041

出　　处：《中国医药》2020年第6期919-922,共4页China Medicine

基　　金：四川省科技计划(2014SZ0095)。

摘　　要：目的探讨医院社区一体化管理对慢性肾衰竭(CRF)患者自我管理能力、焦虑情绪及疾病干预的影响。方法将2015年8月至2016年8月四川大学华西医院收治的CRF患者90例,按照随机数字表法分为对照组和观察组,各45例,分别采用常规护理干预和医院社区一体化管理模式。检测2组患者干预前及干预3个月后肾功能指标(血肌酐和血尿素氮),评价2组患者的生活质量和自我管理能力及抑郁和焦虑情绪。结果干预3个月后,2组患者的血肌酐和血尿素氮水平明显低于干预前[对照组分别为(287±33)μmol/L比(352±40)μmol/L;(9.3±2.5)mmol/L比(18.4±3.5)mmol/L;观察组分别为(232±30)μmol/L比(353±41)μmol/L;(7.3±2.7)mmol/L比(18.2±3.5)mmol/L;均P<0.01],干预3个月后观察组患者血肌酐和血尿素氮水平均明显低于对照组(均P<0.01)。干预3个月后,2组患者的生活质量评分和自我管理能力评分也明显高于干预前(P<0.01),且观察组患者明显高于对照组(P<0.01);2组患者抑郁自评量表和焦虑自评量表评分明显低于干预前,且观察组患者低于对照组(P<0.05)。结论采用医院社区一体化管理模式护理CRF患者,能明显改善患者的肾功能,提高其自我管理能力和生活质量,改善其不良情绪,医院社区一体化管理是一种优质的临床护理模式,具有深远的临床应用价值。Objective To explore the influence of integrated management of hospital-community on anxiety emotion,self-management and disease intervention in patients with chronic kidney disease.Methods From August 2015 to August 2016,90 patients with chronic renal failure(CRF)admitted to West China Hospital of Sichuan University were randomly divided into control group and observation group,with 45 cases in each group.Patients in the two groups were treated with routine nursing intervention and hospital community integration management.The renal function indexes,serum creatinine and blood urea nitrogen were measured before and after 3 months of intervention.The quality of life and self-management were evaluated.The tension and anxiety of the two groups were investigated.Results After 3 months of intervention,serum creatinine and blood urea nitrogen levels were significantly decreased in the both groups[control group(287±33)μmol/L vs(352±40)μmol/L;(9.3±2.5)mmol/L vs(18.4±3.5)mmol/L;observation group(232±30)μmol/L vs(353±41)μmol/L;(7.3±2.7)mmol vs(18.2±3.5)mmol/L;all P<0.01].After 3 months of intervention,the serum creatinine and blood urea nitrogen levels in observation group were significantly lower than those in control group(both P<0.01).The quality of life score and self-management ability score of the two groups were also significantly increased(P<0.01);observation group was significantly higher than control group(P<0.01).The self-rating depression scale and self-rating anxiety scale of the two groups were significantly lower than before the intervention.The scores of the observation group were significantly lower than those of control group(all P<0.05).Conclusion The hospital community integrated management mode can significantly improve the renal function,as well as self-management ability,quality of life and the negative emotions.Hospital integrated management is a high-quality clinical nursing model.

关 键 词：慢性肾衰竭 医院社区一体化管理 不良情绪 

分 类 号：R47[医药卫生—护理学]