管路结合预见性护理对糖尿病肾病维持性血液透析患者透析效果及并发症的影响  

The effect of dialysis pipeline combined with predictive nursing strategies in the treatment of diabetic nephropathy patients with maintenance hemodialysis and its influence on complications

作　　者：鹿慧慧 曹青 李玉梅 Lu Huihui;Cao Qing;Li Yumei(Department of Renal Endocrinology,No.904 Hospital,Joint Logistics Support Force of the Chinese People's Liberation Army,Wuxi 214000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇四医院肾脏内分泌科,无锡214000

出　　处：《中国实用护理杂志》2021年第15期1146-1151,共6页Chinese Journal of Practical Nursing

摘　　要：目的探讨透析管路结合预见性护理措施对糖尿病肾病维持性血液透析(MHD)患者透析效果的影响。方法选取2015年1月至2019年12月中国人民解放军联勤保障部队第九○四医院住院的糖尿病肾病MHD患者96例作为研究对象。按照随机数字表法分为对照组和观察组,每组48例。对照组患者应用常规透析管路和其他血液透析护理干预,观察组患者在此基础结合预见性护理措施。比较2组患者干预前后的生化指标、心理状态、依从性、医院感染和并发症发生率及护理满意度。结果护理干预后2组患者的尿素氮(BUN)、肌酐(Cr)、β_(2)微球蛋白(β_(2)-MG)较干预前均降低,且干预后观察组分别为(12.04±1.98)mmol/L、(451.62±82.49)μmol/L、(13.53±2.31)mg/L,均低于对照组的(15.82±2.31)mmol/L、(591.35±99.21)μmol/L、(18.83±2.92)mg/L,差异有统计学意义(t值为8.608、7.503、9.862,P<0.05);干预后观察组患者治疗依从性各分量表得分分别为(29.06±3.58)、(23.42±2.99)、(20.11±3.01)、(14.76±2.94)分,均高于对照组的(31.91±3.97)、(21.53±3.21)、(17.03±2.74)、(12.36±3.04)分,差异有统计学意义(t值为2.985~5.243,P<0.05);干预后2组患者的SAS、SDS评分较干预前均降低,且观察组分别为(39.12±4.82)、(36.43±6.03)分,均低于对照组的(48.25±5.14)、(46.75±5.36)分,差异有统计学意义(t值为8.977、8.862,P<0.05);观察组医院感染和并发症的发生率分别为2.08%(1/48)和4.17%(2/48),均显著低于对照组的14.58%(7/48)和18.75%(9/48),差异有统计学意义(χ^(2)值为4.91、5.26,P<0.05);观察组护理满意度为95.83%(46/48),高于对照组的72.92%(35/48),差异有统计学意义(χ^(2)值为9.56,P<0.05)。结论透析管路结合预见性护理,改善患者的心理状态,降低医院感染及并发症发生率,延长血管通路使用寿命,提高血透患者生命质量,改善护患关系,营造和谐氛围,在临床上值得推广应用。Objective To explore the effect of dialysis pipeline nursing group mode combined with predictive nursing measures on hemodialysis efficacy of diabetic nephropathy patients with maintenance hemodialysis(MHD).Methods A total of 96 patients with MHD of diabetic nephropathy admitted to No.904 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2015 to December 2019 were selected as the research objects and divided into control group and observation group,48 cases in each group.Patients in the control group were treated with routine dialysis pipeline and other hemodialysis nursing interventions,while patients in the observation group were treated with predictive nursing measures on this basis.The biochemical indexes,psychological state,compliance,incidence of nosocomial infection and complications and nursing satisfaction of the two groups before and after intervention were compared.Results After the nursing intervention,the blood urea nitrogen(BUN),creatinine(Cr),andβ_(2) microglobulin(β_(2)-MG)of the two groups of patients were lower than those before the intervention,and the BUN of the observation group after the intervention,Cr andβ_(2)-MG were(12.04±1.98)mmol/L,(451.62±82.49)μmol/L,(13.53±2.31)mg/L,respectively,which were lower than those of the control group(15.82±2.31)mmol/L,(591.35±99.21)μmol/L,(18.83±2.92)mg/L,the difference was statistically significant(t value was 8.608,7.503,9.862,P<0.05).After the intervention,the scores of the treatment compliance subscales of the observation group were 29.06±3.58,23.42±2.99,20.11±3.01,14.76±2.94,which were higher than those of the control group(31.91±3.97,21.53±3.21,17.03±2.74,12.36±3.04),the difference was statistically significant(t value was 2.985-3.932,P<0.05).After the intervention,the SAS and SDS scores of the two groups were lower than those before the intervention,and the SAS and SDS scores of the observation group after intervention were 39.12±4.82 and 36.43±6.03,which were lower than those of the cont

关 键 词：透析管路 预见性护理 维持性血液透析 糖尿病 透析效果 并发症 

分 类 号：R473.5[医药卫生—护理学]