王景紅 徐蘭
[摘要] 目的 探討綜合護理在尿毒癥患者血透并發(fā)癥發(fā)生中的影響干預效果。 方法 選擇2017年12月~2019年1月本院收治的尿毒癥實施長期血液透析治療者80例,按照隨機數(shù)字表法分為兩組,各40例。對照組行常規(guī)護理,觀察組則實施綜合護理干預,對所有患者治療后3 d情況進行復查,比較干預后兩組尿素氮和肌酐水平變化情況,血鈣及血磷水平變化,統(tǒng)計兩組干預過程中出現(xiàn)的并發(fā)癥情況。 結果 干預后觀察組尿素氮水平為(6.1±0.7) mmol/L,低于對照組的(16.1±2.8) mmol/L(P<0.05),肌酐水平為(80.9±6.9)μmol/L,低于對照組的(216.5±16.6)μmol/L(P<0.05),干預過程中,觀察組并發(fā)癥發(fā)生率為5.0%,顯著低于對照組的27.5%(P<0.05)。 結論 針對長期血液透析患者,實施有效的綜合護理干預,對促進腎功能恢復,減少并發(fā)癥發(fā)生有重要價值。
[關鍵詞] 綜合護理;尿毒癥;長期血透;并發(fā)癥
[中圖分類號] R473.5? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701(2020)06-0176-03
[Abstract] Objective To investigate the intervention effect of comprehensive nursing on the effects of hemodialysis-related complications in the patients with uremia. Methods 80 patients with uremia receiving long-term hemodialysis who were admitted to our hospital from December 2017 to January 2019 were selected.According to the random number table method, they were divided into two groups, with 40 cases in each group. The control group was given routine nursing care, and the observation group was given comprehensive nursing intervention. All patients were given re-examination 3 days after treatment.The changes of urea nitrogen and creatinine levels, blood calcium and blood phosphorus levels were compared between the two groups after intervention. The complications that occurred during the intervention in both groups were statistically analyzed. Results After intervention, the level of urea nitrogen in the observation group was (6.1±0.7) mmol/L, which was lower than that in control group [(16.1±2.8) mmol/L] before intervention (P<0.05). The creatinine level was (80.9±6.9) μmol/L, which was lower than that in control group [(216.5±16.6) μmol/L] before intervention(P<0.05). During the intervention, the incidence rate of complications in the observation group was? 5.0%, which was significantly lower than that of 27.5% in the control group(P<0.05). Conclusion For long-term patients with uremia receiving hemodialysis, the implementation of effective comprehensive nursing intervention is of great value in promoting renal function recovery and reducing complications.
[Key words] Comprehensive intervention; Uremia; Long-term hemodialysis; Complications
據(jù)統(tǒng)計當前世界范圍內依靠長期血液透析以維系生命的尿毒癥患者超過80%[1],尤其對于晚期腎功能衰竭者,長期血液透析治療是延長患者生命的最有效方法[2-3]。隨著醫(yī)療理念及醫(yī)療技術更新,臨床針對長期血液透析患者的關注度日益提高,其不僅局限于延長患者生命周期,而且對治療過程中患者生存時間及生活質量引起顯著重視[4]。
對于尿毒癥患者行血液透析對延長患者生存時間有重要意義,但部分患者在治療過程中易出現(xiàn)各種并發(fā)癥,而且降低長期血液透析患者的生活質量,對其治療依從性亦有一定負面影響[5]。同時患者的治療依從性與否直接影響到長期血液透析治療的效果[6-7]。故在對尿毒癥患者實施長期血液透析治療同時,應充分告知患者提高治療依從性的方法,并提高自我管理能力,加強健康宣教,減少并發(fā)癥。本研究則主要探討綜合護理對尿毒癥患者血透并發(fā)癥發(fā)生率的影響,現(xiàn)報道如下。
綜合護理能為患者盡量爭取更專業(yè)、精細且系統(tǒng)化的護理服務,告知實施長期血液透析治療的注意事項、進行全程的精心心理護理,尤其針對可能發(fā)生的并發(fā)癥實施早期的防范,加強對患者病情變化的重視[15,16]等有關。
綜上所述,針對長期血液透析患者,實施有效的綜合護理干預,對促進腎功能恢復,減少并發(fā)癥發(fā)生有重要價值。
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(收稿日期:2019-09-20)