4R理念循证路径对慢性肾衰竭腹膜透析患者的应用效果  

Application Effect of the 4R Concept Evidence-Based Pathway on PeritonealDialysis Patients with Chronic Renal Failure

作　　者：刘飞扬 苗金红[2] 王琦[3] LIU Feiyang;MIAO Jinhong;WANG Qi(Department of Nephrology,the First Affiliated Hospital of University,Zhengzhou 450000,China;Quality Management Department,the First Affiliated Hospital of University,Zhengzhou 450000,China;Ward 3,Department of Infectious Diseases,the First Affiliated Hospital of University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院肾病科,河南郑州450000 [2]郑州大学第一附属医院质量控制处,河南郑州450000 [3]郑州大学第一附属医院感染性疾病科三病区,河南郑州450000

出　　处：《河南医学研究》2024年第12期2286-2289,共4页Henan Medical Research

基　　金：河南省中医药科学研究专项课题(2021 JDZX2011)。

摘　　要：目的 观察4R理念循证路径对慢性肾衰竭(CRF)腹膜透析患者肾小球滤过率及远期生活质量的影响。方法 前瞻性招募2022年4月至2023年10月郑州大学第一附属医院接受腹膜透析的慢性肾衰竭患者,共84例。通过计算机随机数法简单抽样分组为观察组和常规组,每组42例。常规组接受肾病内科常规护理方式,观察组接受4R理念模式循证护理路径干预,两组持续护理干预2个月。比较两组临床有效率、肾病生活质量短表(KDQOL-SF)、贝克抑郁量表(BDI-Ⅱ)、并发症发生率、患者满意度评分。结果 观察组临床治疗有效率高于对照组(P<0.05)。护理后两组KDQOL-SF量表得分较治疗前升高,且观察组得分高于对照组(P<0.05)。两组护理后BDI-Ⅱ量表得分较护理前降低,观察组BDI-Ⅱ得分低于对照组(P<0.05)。观察组并发症发生率低于对照组(P=0.013)。观察组患者满意度评分(91.17±10.55)高于对照组(84.54±8.54)(P=0.019)。结论 4R理念循证路径可改善CRF腹膜透析患者治疗有效率,提高生活质量及护理满意度,降低不良反应发生率。Objective To observing the impact of the 4R concept evidence-based pathway on glomerular filtration rate and long-term quality of life in patients with chronic renal failure(CRF).Methods Prospective recruitment of 84 patients with chronic renal failure who underwent peritoneal dialysis at the First Affiliated Hospital of Zhengzhou University from April 2022 to October 2023.According to computer random number method,the group was randomly divided into an observation group and a control group,with 42 cases in each group.The conventional group received routine nursing care from the nephrology department,while the observation group received evidence-based nursing intervention using the 4R concept model.Both groups received continuous nursing intervention for 2 months.The clinical efficacy,Kidney disease quality of life short form(KDQOL-SF),Becker depression inventory(BDI-Ⅱ),incidence of complications and patient satisfaction scores between two groups were compared.Results The effective rate of clinical treatment of the observation group was higher than that of the control group(P<0.05).After nursing,the KDQOL-SF scores of the two groups increased compared to before treatment,and the observation group had higher scores than the control group(P<0.05).After nursing,the BDI-Ⅱscore of the two groups decreased compared to before nursing,and the BDI-Ⅱscore of the observation group was lower than that of the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P=0.013).The satisfaction score of patients in the observation group(91.17±10.55)was higher than that in the control group(84.54±8.54)(P=0.019).Conclusion The 4R concept evidence-based pathway can improve the treatment efficiency,quality of life and nursing satisfaction of CRF peritoneal dialysis patients and reduce the incidence of adverse reactions.

关 键 词：慢性肾衰竭 腹膜透析 循证护理 4R理念 肾小球滤过率 生活质量 

分 类 号：R471[医药卫生—护理学]