失效模式和效果分析对维持性血液透析患者营养和心理状态的作用  

Effects of failure mode effect analysis in nutritional and psychological conditions in maintaining hemodialysis patients

作　　者：缪雪兰 吴晓芳[1] 史燕飞 Miu Xuelan;Wu Xiaofang;Shi Yanfei(Hemodialysis Room,Liyang City People's Hospital Jiangsu Province,Suzhou 213300,Jiangsu,China;Hemodialysis Room,Jiulong Hospital,Suzhou 215000,Jiangsu,China)

机构地区：[1]江苏省溧阳市人民医院血透室,江苏溧阳213300 [2]江苏省苏州九龙医院血透室,江苏苏州215000

出　　处：《中国医学前沿杂志（电子版）》2022年第3期19-23,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探究失效模式和效果分析(failure mode and effect analysis,FMEA)对维持性血液透析(maintenance hemodialysis,MHD)患者营养和心理状态的作用。方法选取江苏省溧阳市人民医院2020年1—12月接受维持性血液治疗的118例患者,按照随机数字表法将患者分为对照组和观察组(各59例)。对照组实施常规干预,观察组在对照组基础上实施FMEA干预模式。观察并比较两组干预前后血清营养学指标、营养不良等级状况和自我感受负担感。结果干预前,两组血清营养学指标、营养状况比例以及自我感受负担比较,差异无统计学意义(P>0.05)。干预4周后,观察组血清营养学指标中,血清前白蛋白(pre-albumin,PA)、白蛋白(albumin,ALB)、总蛋白(total protein,TP)水平高于对照组,两组均高于干预前(P<0.05)。干预4周后,观察组营养等级明显高于对照组,观察组高于干预前(P<0.05)。干预4周后,观察组自我感受负担感评分低于对照组,两组评分高于干预前(P<0.05)。结论FMEA模式有效改善MHD患者血清营养学指标水平和营养等级分级,提高患者自我价值感,消除其自我感受负担,有助于提高远期预后,值得临床借鉴与推广。Objective To explore the effects of failure mode and effect analysis(FMEA)in nutritional and psychological conditions in patients with maintaining hemodialysis(MHD).Method A total of maintaining hemodialysis 118 patients were enrolled in Liyang City People􀆳s Hospital of Jiangsu Province from January 2020 to December 2020.All patients were divided into the observation group and the control group with 59 cases in each group.The control group received routine intervention,and the observation group implemented FMEA besides the routine intervention.The serum nutritional indicators,malnutrition rating status and self-feeling score were compared between the two groups.Result The serum nutrition indicators,proportion of nutritional status,and self-feeling burden were not significant different before intervention(P>0.05).After 4 weeks of intervention,the serum pre-albumin(PA),albumin(ALB),total protein(TP)level was higher in the observational group than the control group.Those markers after intervention were significant higher than baseline(P<0.05).After 4 weeks of intervention,the self-feeling score in observation group was lower than the control group(P<0.05).Two sets of sores after intervention were higher than that before intervention(P<0.05).Conclusion The FMEA may effectively improve the level of serum nutritional indicators and nutritional grades in MHD patients.It also may alleviate the degree of self-worth,and decrease the degree of self-burden,and improve the prognosis.FMEA may worth clinical reference and promotion.

关 键 词：失效模式和效果分析 维持性血液透析 营养指标 心理状态 

分 类 号：R473.5[医药卫生—护理学]