以护士为主导的多学科管理在维持性血液透析高磷血症患者中的应用  

Application of nurse led multidisciplinary management in hyperphosphatemia patients with maintenance hemodialysis

作　　者：李炎[1] 岳晓红[1] Li Yan;Yue Xiaohong(Blood Purification Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院血液净化中心,郑州450000

出　　处：《中华现代护理杂志》2023年第1期66-71,共6页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2019年护理学科研究课题(CMAPH-NRI2019012)。

摘　　要：目的探讨以护士为主导的多学科管理对维持性血液透析(MHD)高磷血症患者血磷自我管理效能及遵医行为的影响。方法采用便利抽样法选择2021年3—9月郑州大学第一附属医院的MHD患者226例,根据随机数字表法分为对照组和观察组,各113例。对照组采取常规高磷血症管理,观察组在对照组基础上实施以护士为主导的多学科高磷血症管理,为期3个月。比较两组生化指标、血磷自我管理效能和血磷控制遵医行为的差异。结果干预后观察组患者血磷、血钙和甲状旁腺激素均低于对照组,且均低于同组干预前,差异有统计学意义(P<0.05);干预后观察组血磷自我管理效能和血磷控制遵医行为各维度得分及总分均高于对照组,且高于同组干预前,差异有统计学意义(P<0.05)。结论以护士为主导的多学科管理可以有效提高MHD高磷血症患者血磷自我管理效能和遵医行为,与常规管理相比降磷及改善钙磷代谢紊乱效果更好。Objective To explore the effect of nurse led multidisciplinary management on blood phosphorus self-management efficacy and compliance behavior of hyperphosphatemia patients with maintenance hemodialysis(MHD).Methods From March to September 2021,226 MHD patients in the First Affiliated Hospital of Zhengzhou University were selected by convenient sampling.According to the method of random number table,the patients were divided into control group and observation group with 113 cases each.The control group adopted routine management of hyperphosphatemia,while the observation group implemented multidisciplinary management of hyperphosphatemia led by nurses on the basis of the control group,lasting for three months.The biochemical indexes,blood phosphorus self-management efficacy and blood phosphorus control compliance behavior were compared between the two groups.Results After intervention,the blood phosphorus,blood calcium and parathyroid hormone in the observation group were lower than those in the control group,and were lower than those in the same group before intervention,with statistically significant differences(P<0.05).After intervention,the scores and total scores of blood phosphorus self-management efficacy and blood phosphorus control compliance behavior in the observation group were higher than those in the control group,and were higher than those in the same group before intervention,with statistically significant differences(P<0.05).Conclusions The multidisciplinary management led by nurses can effectively improve the blood phosphorus self-management efficacy and compliance behavior of hyperphosphatemia patients with MHD.It is better than the routine management in reducing phosphorus and improving calcium and phosphorus metabolism disorder.

关 键 词：透析 高磷血症 多学科管理 自我效能 遵医行为 

分 类 号：R473.5[医药卫生—护理学]