维持性血液透析串联血液灌流中预见性干预方案的应用效果  

Application effect of predictive intervention program in maintenance hemodialysis patients combined with hypertension

作　　者：汪娟[1] 金莉[2] 张世同[1] 黄海宁[1] 白先莉 WANG Juan;JIN Li;ZHANG Shi-tong;HUANG Hai-ning;BAI Xian-li(Lu'an Traditional Chinese Medicine Hospital,Lu'an,Anhui 237006,China)

机构地区：[1]六安市中医院血液净化中心,安徽六安237006 [2]六安市中医院肾病科,安徽六安237006

出　　处：《中华医院感染学杂志》2024年第7期1116-1120,共5页Chinese Journal of Nosocomiology

基　　金：安徽省护理学会科研课题立项项目(AHHLb202115)。

摘　　要：目的分析预见性干预在接受维持性血液透析联合血液灌流患者中的应用效果。方法纳入2021年11月-2023年5月在六安市中医院接受维持性血液透析联合血液灌流的病例102例为研究对象,随机划入对照组及试验组(n=51)。对照组接受常规护理,试验组在对照组的基础上接受预见性护理干预。比较两组护理后各类感染的发生率、营养与生化指标水平、炎症因子水平、心理状态、生活质量和护理满意度。结果试验组患者感染发生率1.52%低于对照组4.85%(P<0.05);护理后试验组患者白蛋白(ALB)及前白蛋白(PALB)水平高于对照组患者(P<0.05);护理后试验组患者白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、内毒素及铁蛋白水平低于对照组患者(P<0.05);试验组患者IL-10水平高于对照组患者(P<0.05);护理后试验组患者焦虑自评量表(SAS)及抑郁自评量表(SDS)评分均低于对照组患者(P<0.05);护理后试验组患者SF-36评分与对照组相比增加(P<0.05);试验组患者护理总满意率为98.04%,高于对照组患者76.47%(P<0.05)。结论预见性透析干预可降低维持性血液透析联合血液灌流患者感染风险,在一定程度上增加了机体营养物质的水平,降低了机体炎症反应。OBJECTIVE To probe the impact of predictive intervention on patients receiving hemoperfusion com-bined with maintenance hemodialysis.METHODS A total of 102 patients receiving hemoperfusion combined with maintenance hemodialysis in Lu'an Traditional Chinese Medicine Hospital from Nov 2021 to May 2023 were en-rolled.They were randomly divided into the control group and experimental group(n=51).The control group re-ceived routine nursing,and the experimental group received predictive nursing intervention based on the control group.The incidence of various types of infection,nutritional and biochemical indexes,inflammatory factors,psy-chological state,life quality,and nursing satisfaction were compared between the two groups.RESULTS The inci-dence of infection in the experimental group was 1.52%,which was lower than that in in the control group 4.85%(P<0.05).After nursing,the levels of albumin(ALB)and pre-albumin(PALB)in the experimental group were higher than those in the control group(P<0.05).The content of interleukin(IL)-6,tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),endotoxin and ferritin in the experimental group was lower than those in the control group(P<0.05);After nursing,IL-10 level in the experimental group was higher than that in the control group(P<0.05);self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores in the experimen-tal group were lower than those in the control group(P<0.05);SF-36 score in the experimental group was in-creased compared with the control group(P<0.05).The total nursing satisfaction rate in the experimental group was 98.04%,which was higher than that in the control group(76.47%)(P<0.05).CONCLUSION Predictive nursing intervention could significantly reduce the risk of infection in maintenance hemodialysis patients combined with hypertension,increase the body's nutrients and reduce the inflammatory response.

关 键 词：预见性干预 维持性血液透析 血液灌流 感染 应用效果 

分 类 号：R459.5[医药卫生—治疗学]