单病种护理路径干预在维持性血液透析患者中的应用效果  

Application effect of single disease nursing pathway intervention in patients with maintenance hemodialysis

作　　者：杨柳[1] 赵琳娜[1] 武海捷[1] 邵莉[1] Yang Liu;Zhao Linna;Wu Haijie;Shao Li(Hemodialysis Room,Health Care Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院医疗保健中心血液透析室,100050

出　　处：《中华现代护理杂志》2020年第30期4265-4269,共5页Chinese Journal of Modern Nursing

摘　　要：目的:观察单病种护理路径干预在维持性血液透析(MHD)患者中的应用效果。方法:采用便利抽样法,选取2018年6月—2019年6月于首都医科大学附属北京友谊医院行MHD治疗的128例患者,采用随机数字表法分为单病种护理组和常规护理组,各64例。常规护理组给予常规MHD护理干预,单病种护理干预组在常规护理干预的基础上,基于临床护理路径,针对首次透析患者、透析间期患者、维持性透析期患者制订单病种护理路径进行护理干预。干预6个月后,比较两组患者对透析知识的掌握情况、并发症发生率及透析耐受度。结果:单病种护理组患者饮食原则、功能锻炼、用药原则、急慢性并发症、内瘘及静脉置管5个方面评分及透析知识总分均高于常规护理组;单病种护理组的渗血、血栓发生率及总体并发症发生率均低于常规护理组;单病种护理组患者的肾脏病为目标的评估、生活质量评估得分以及透析生活质量问卷总得分均高于常规护理组;差异均有统计学意义(P<0.05)。结论:单病种护理路径干预能够提高MHD患者透析知识掌握程度,降低并发症发生率,改善患者透析耐受度。Objective To observe the application effect of single disease nursing pathway intervention in patients with maintenance hemodialysis.Methods Using the convenient sampling method,a total of 128 patients who underwent MHD treatment in Beijing Friendship Hospital of Capital Medical University from June 2018 to June 2019 were selected.They were divided into the single disease nursing group and routine nursing group by random number table method,with 64 cases in each group.The routine nursing group was given routine MHD nursing intervention.On the basis of routine nursing intervention and based on clinical nursing pathway,the single-disease nursing intervention group formulated the single-disease nursing pathway for the first-time dialysis patients,interdialytic patients and maintenance dialysis patients for nursing intervention.After 6 months of intervention,mastery of dialysis knowledge,complication rate and dialysis tolerance were compared between two groups.Results The scores of five aspects of diet principles,functional exercise,medication principles,acute and chronic complications,internal fistulas and venous catheterization in the single-disease nursing group and the total score of dialysis knowledge were all higher than those of the routine nursing group.The incidence of bleeding,thrombosis and overall complications in the single-disease nursing group were lower than those in the routine nursing group.The scores of kidney disease-targeted assessment,quality of life assessment and total score of dialysis quality of life questionnaire for patients in the single-disease nursing group were higher than those of the routine nursing group.All differences were statistically significant(P<0.05).Conclusions Single-disease nursing pathway intervention can improve the knowledge of dialysis in MHD patients,reduce the incidence of complications and improve the tolerance of patients with dialysis.

关 键 词：透析 维持性血液透析 单病种 护理路径 并发症 透析耐受度 

分 类 号：R473.5[医药卫生—护理学]