容量自我管理的教育与随访对持续非卧床腹膜透析患者心功能的影响

Influence of volume self- management education and follow- up visit on cardiac functions of continuous ambulatory peritoneal dialysis patients

目的：探讨容量自我管理的教育与随访对持续非卧床腹膜透析患者心功能的影响。方法：选取2014年4月~2015年4月在我院腹膜透析中心规律门诊随访的持续非卧床腹膜透析患者60例,随机等分为对照组和观察组,对照组实施常规护理,观察组在对照组的基础上行实施自我管理教育。比较两组患者容量管理能力、对容量负荷的影响及血浆BNP浓度变化。结果：干预12个月后,两组患者的容量管理能力各项得分均较干预前有所提高,但观察组各项得分的提高均较对照组显著（P〈0.05）;观察组重度水肿者明显减少,且无水肿者明显增多,患者体重、收缩压和24 h超滤量均显著下降,患者BNP≥100 pg/ml的人数明显少于对照组,且差异均具有统计学意义（P〈0.05）。结论：容量自我管理教育与随访可有效提高患者容量管理能力,显著减少容量负荷,改善心功能水平,值得临床推广应用。

Objective： To discuss the influence of volume self- management education and follow- up visit on the cardiac functions of continuous ambulatory peritoneal dialysis patients. Methods： Selected 60 cases of continuous ambulatory peritoneal dialysis patients receiving regular outpatient follow- up in our hospital＇s Peritoneal Dialysis Center in the period from April 2014 to April 2015 were selected,and equally divided into control group and observation group at random,in which,the patients from the control group received the conventional nursing,and the patients from the observation group received self- management education on the basis of that to the control group. Then,these two groups of patients were compared in volume management capability,influence on volume load,and plasma BNP concentration change. Results： After the intervention for over 12 months,both of the two groups had an increase in scoring of various items of volume management capability,however,the observation group was superior to the control group in scoring of various items（ P〈0. 05）; in the observation group,there were significantly reduced severe edema patients and obviously increased patients without edema,patients＇ weight,systolic pressure,and 24 h ultrafiltration volume all reduced sharply,and the observation group had fewer patients with BNP≥100 pg / ml than the control group,and all the differences were of statistical significance（ P〈0. 05）. Conclusion： Volume self- management education and follow- up visit could effectively improve the volume management capability of patients,obviously reduce the volume load,and improve the cardiac function level,so it＇s worthy of popularization.