基于ORTCC模型联合抗阻训练对维持性血液透析肌少症患者握力、依从性和步速的影响  

Influence of ORTCC model-based specialist nursing combined with resistance training on grip strength, compliance and walking speed in maintenance hemodialysis patients with sarcopenia

作　　者：李梅莹 张斯萍 LI Meiying;ZHANG Siping(Blood Purification Center,Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital),Jiangsu,Nanjing 210000,China)

机构地区：[1]南京医科大学附属南京医院江苏省南京市第一医院血液净化中心,南京市210000

出　　处：《河北医药》2024年第24期3745-3749,共5页Hebei Medical Journal

摘　　要：目的探究基于目标-规则-训练-考核-文化(ORTCC)模型的专科护理联合抗阻训练对维持性血液透析(MHD)肌少症患者握力、依从性和步速的影响。方法选取2020年1月至2023年11月就诊的100例MHD肌少症患者为研究对象,随机分为观察组和对照组,每组50例。对照组患者予以常规护理联合抗阻训练干预,观察组患者在对照组的基础上予以基于ORTCC模型的专科护理,观察2组患者经干预前后骨骼肌质量[四肢骨骼肌质量(ASM)、骨骼肌质量指数(SMI)、全身四肢骨骼肌质量指数(ASMI)]、躯体功能[简易机体功能评估表(SPPB)、步速、握力]、生存质量[肌肉衰退症专用生活质量量表(SarQoL)]的变化及干预期间依从性。结果2组患者经干预后相较干预前在ASM、SMI、ASMI、SPPB评分、步速、握力水平、SarQoL量表7个维度评分上明显升高(P<0.05),且观察组患者相较对照组患者在上述指标上明显更高,差异有统计学意义(P<0.05);观察组患者相较对照组患者在干预期间用药规范、合理饮食、运动训练、定期复诊上依从率明显更高(P<0.05)。结论将基于ORTCC模型的专科护理联合抗阻训练应用于MHD肌少症患者可增加治疗依从性,改善骨骼肌质量,增加患者的握力和步速,有助于躯体功能及生存质量恢复,值得临床推广应用。Objective To explore the influence of specialist nursing based on the orientation-rules-training-check-culture(ORTCC)model combined with resistance training on grip strength,compliance and walking speed in patients with sarcopenia undergoing maintenance hemodialysis(MHD).Methods A total of 100 MHD patients with sarcopenia from January 2020 to November 2023 were selected as the study subjects,and they were randomly divided into observation group(n=50)and control group(n=50).The patients in the control group were given routine nursing combined with resistance training intervention,while those in the observation group additionally carried out ORTCC model-based specialist nursing.The changes in skeletal muscle mass(appendicular skeletal muscle mass[ASM],skeletal muscle mass index[SMI],appendicular skeletal muscle mass index[ASMI]),physical function(Short Physical Performance Battery[SPPB],walking speed,grip strength)and quality of life(The Sarcopenia&Quality of Life Scale[SarQoL])before and after intervention,and the compliance rates during intervention were observed in the two groups.Results After intervention,the ASM,SMI,ASMI,SPPB score,walking speed,grip strength level and scores of seven dimensions of SarQoL scale were enhanced significantly in the two groups than those before intervention(P<0.05),which were significantly higher in observation group than those of control group(P<0.05).The compliance rates of medication specification,reasonable diet,exercise training and regular follow-up were significantly higher in observation group than those of control group during intervention(P<0.05).Conclusion The application of ORTCC model-based specialist nursing combined with resistance training in MHD patients with sarcopenia can improve treatment compliance,skeletal muscle mass,grip strength and walking speed,and contribute to the recovery of physical function and quality of life.

关 键 词：ORTCC模型 专科护理 抗阻训练 维持性血液透析 肌少症 依从性 

分 类 号：R459.52[医药卫生—治疗学]