上肢康复操联合聚焦解决模式下健康教育在老年血液透析患者中的应用效果

Application Effect of Upper Limb Rehabilitation Exercise Combined with Health Education Under Focused Solution Mode in Elderly Hemodialysis Patients

目的分析上肢康复操联合聚焦解决模式下健康教育对老年血液透析患者的影响效果.方法选取该院2020年1月—2023年7月收治的68名老年血液透析患者作为研究对象,根据随机数字编号法将其分为对照组与观察组,各34例.对照组采用常规干预及聚焦解决模式下健康教育,观察组采用上肢康复操联合聚焦解决模式下健康教育.比较两组患者的握力、动静脉内瘘血流量、非内瘘侧头静脉直径及自我管理水平.结果干预3个月后,观察组内瘘侧和非内瘘侧握力分别为(28.98±7.82)kg、(32.76±8.14)kg,均大于对照组的(25.69±6.68)kg、(26.70±5.23)kg,组间差异有统计学意义(P<0.05);观察组动静脉内瘘血流量为(795.85±367.31)mL/min,多于对照组的(639.94±294.17)mL/min,非内瘘侧头静脉直径为(2.53±0.33)mm,长于对照组的(2.28±0.36)mm,组间差异有统计学意义(P<0.05);观察组中自我管理能力量表中的遵医治疗、合理饮食和运动、用药依从性及动静脉内瘘护理评分分别为(83.92±7.15)分、(84.86±7.02)分、(86.22±6.78)分、(83.12±7.15)分,均高于对照组的(80.17±6.81)分、(80.17±6.81)分、(82.51±6.45)分、(79.24±6.88)分,组间差异有统计学意义(P<0.05).结论上肢康复操联合聚焦解决模式下健康教育,可提升老年血液透析患者的自我管理能力,并促进患者上肢握力的恢复,有利于动静脉内瘘的维护.

Objective To analyze the effect of health education on elderly hemodialysis patients under the mode of upper limb rehabilitation exercise combined with focused solution.Methods 68 elderly hemodialysis patients admitted to the hospital from January 2020 to July 2023 were selected as the study objects,and were divided into a control group and an observation group according to random number numbering method,with 34 cases in each group.The control group received routine intervention and focused solution mode health education,and the observation group received upper limb rehabilitation exercise combined focused solution mode health education.The grip strength,arteriovenous fistula blood flow,non-arteriovenous cephalic vein diameter and self-management level were compared between the two groups.Results After 3 months of intervention,the grip strength of the internal fistulas and non-internal fistulas in the observation group was(28.98±7.82)kg and(32.76±8.14)kg,respectively,which were greater than(25.69±6.68)kg and(26.70±5.23)kg of the control group,and the differences were statistically significant(P<0.05);the arteriovenous fistula blood flow in the observation group was(795.85±367.31)mL/min,which was higher than(639.94±294.17)mL/min in the control group,and the diameter of the non-internal cephalic vein was(2.53±0.33)mm,which was longer than(2.28±0.36)mm in the control group,the differences between groups were statistically significant(P<0.05);in the self-management ability scale of the observation group,the scores of compliance treatment,reasonable diet and exercise,medication compliance and arterio-venous fistula nursing were(83.92±7.15)points,(84.86±7.02)points,(86.22±6.78)points and(83.12±7.15)points respectively,they were higher than(80.17±6.81)points,(80.17±6.81)points,(82.51±6.45)points and(79.24±6.88)points of the control group,and there were statistical significance between groups(P<0.05).Conclusion Upper limb rehabilitation exercise combined with health education under focused solution mode can improve the self-management ability of elderly hemodialysis patients and promote the recovery of upper limb grip strength,which is conducive to the maintenance of arteriovenous fistula.