血液透析症状性低血压原因及预防护理措施研究  

Study on the causes of symptomatic hypotension in hemodialysis and preventive nursing measures

作　　者：胡半千 Hu Banqian(The People's Hospital of Huazhou City,Huazhou,Guangdong 525100)

机构地区：[1]化州市人民医院,广东化州525100

出　　处：《基层医学论坛》2022年第9期11-14,共4页The Medical Forum

摘　　要：目的探讨血液透析症状性低血压原因及预防护理措施。方法采用随机数字表法将78例于2018年1月—2020年1月在化州市人民医院行血液透析的患者分为2组,各39例,对患者血液透析症状性低血压原因进行分析,对照组施以常规护理,试验组施以预见性护理模式,对患者护理前及护理2个月后焦虑评分(SAS)、抑郁评分(SDS)的变化情况、低血压发生率、医院感染发生率、护理满意度、透析依从性评分进行观察。结果护理前,2组SAS评分、SDS评分未表现出显著差异(P>0.05);护理2个月后,试验组的SAS评分、SDS评分明显低于对照组,并且试验组的低血压发生率、医院感染发生率明显低于对照组,护理满意度与透析依从性评分明显高于对照组(P<0.05)。通过临床分析显示,有效血容量不足、自主神经病变、心脏功能异常、失液及失血、透析液原因、透析膜生物相容性的影响、年龄等为导致患者血液透析症状性低血压的重要因素。结论血液透析中较易发生症状性低血压情况,需要对其诱发原因进行明确;采取预见性护理措施具有积极作用,不仅能够有效降低症状性低血压的发生率,同时能够降低SAS、SDS评分及医院感染发生率,提升护理满意度与透析依从性。Objective To explore the causes of symptomatic hypotension on hemodialysis and the effects of preventive care measures.Methods A random number table method was used to divide 78 patients who underwent hemodialysis in our hospital from January 2018 to January 2020,39 cases in each group.The causes of symptomatic hypotension on hemodialysis were analyzed,and the control group Conventional nursing mode was applied,and the experimental group applied predictive nursing mode.The changes of anxiety(SAS)score,depression(SDS)score,incidence of hypotension,and incidence of nosocomial infection before and 2 months after nursing,Nursing satisfaction,dialysis compliance scores were observed.Results Before nursing,the patients'SAS score and SDS score showed no significant difference(P>0.05);after 2 months of nursing,the SAS score and SDS score of the experimental group were significantly reduced,and the incidence of hypotension in the experimental group and hospital The incidence of infection was significantly lower than that of the control group,and the scores of nursing satisfaction and dialysis compliance were significantly higher than those of the control group(P<0.05).Clinical analysis shows that effective blood volume deficiency,autonomic neuropathy,cardiac dysfunction,fluid loss and blood loss,causes of dialysate,influence of dialysis membrane biocompatibility,age,etc.are important factors leading to symptomatic hypotension in patients with hemodialysis.Conclusion Symptomatic hypotension is more likely to occur in hemodialysis,and the cause needs to be clarified;predictive nursing measures have a positive effect,not only can effectively reduce the incidence of symptomatic hypotension,but also reduce the SAS score,SDS score,hospital infection rate,and improve nursing satisfaction and dialysis compliance score.

关 键 词：血液透析 症状性低血压 原因 预见性护理 

分 类 号：R459.5[医药卫生—治疗学]