PDCA循环对微量泵注射多巴胺预防连续性血液净化过程中低血压的影响

Effect of PDCA cycle in the prevention of hypotension during continuous blood purification by micro- pump injection of dopamine

目的：探讨PDCA循环在微量泵注射多巴胺预防连续性血液净化过程中低血压的应用效果。方法：选择2015年1~6月接受微量泵注射多巴胺治疗的42例血液净化低血压患者作为对照组,治疗期间应用常规性护理;选择2015年7~12月接受微量泵注射多巴胺治疗的42例血液净化低血压患者作为观察组,治疗期间应用PDCA循环护理模式,对比分析两组患者治疗效果、不良反应、护理满意度及血压变化情况。结果：观察组低血压、微量泵阻塞、多巴胺渗漏、肢体肿胀、内瘘血栓发生率及护理纠纷发生率均低于对照组（P〈0.05）。观察组患者净化后1,2,3d收缩压、舒张压均高于对照组（P〈0.05）。观察组在健康教育、医疗环境、心理护理、服务态度及操作性护理方面满意度评分高于对照组（P〈0.05）。结论：PDCA循环能有效预防血液透析低血压的发生,降低微量泵临床应用风险事件及意外事件的发生,提高患者治疗满意度。

Objective： To explore the application effect of PDCA cycle in the prevention of hypotension during continuous blood purification by micro- pump injection of dopamine. Methods： Selected 42 cases of patients with hypotension during blood purification dated from January 2015 to June 2015 who received treatment of micro- pump injection of dopamine as control group. During the treatment,they were treated with routine nursing. Selected 42 cases of patients with hypotension during blood purification dated from July 2015 to December 2015 who received treatment of micro- pump injection of dopamine as observation group. During the treatment,they were treated with PDCA cycle nursing. The therapeutic effect,adverse reaction,nursing satisfaction and blood pressure were compared between the two groups. Results： The incidence of hypotension,micro- pump obstruction,dopamine leakage,limb swelling,internal fistula thrombosis and nursing disputes of the observation group were lower than that of the control group（ P〈0. 05）. One,two,three days after the purification,the systolic blood pressure and diastolic blood pressure of the observation group were significantly higher than those of the control group（ P〈0. 05）.The satisfaction score in health education,medical environment,psychological nursing,service attitude and operation nursing of the observation group was higher than that of the control group（ P〈0. 05）. Conclusion： PDCA cycle can effectively prevent the occurrence of hemodialysis hypotension and reduce the risk of accidents of clinical application of micro- pump,therefore improving patients satisfaction with the treatment.