综合性护理干预在结肠透析治疗早期慢性肾功能衰竭患者中的应用

Comprehensive nursing in patients with early chronic renal failure treated by colonic dialysis

目的探讨综合性护理干预在结肠透析治疗早期慢性肾功能衰竭患者中的应用价值。方法选取2013年6月至2015年4月本院收治的早期慢性肾功能衰竭并行结肠透析治疗的患者80例为研究对象,随机分为观察组和对照组(每组各40例),对照组实施常规护理干预,观察组给予综合性护理干预。对比两组临床症状缓解情况,血肌酐(SCr)、血尿素氮(BUN)及血尿酸(UA)水平,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)、SF-36健康调查简表(SF-36)评价两组焦虑抑郁情绪状态及生活质量,并分析两组治疗依从性。结果干预前,两组腰膝酸软、恶心呕吐、乏力、脘腹胀满、食少纳呆、浮肿及总症状各项积分比较,差异均无统计学意义(P>0.05);干预后,观察组上述各项评分均显著低于对照组(P<0.05)。干预前,两组SCr、BUN、UA水平比较,差异均无统计学意义(P>0.05);干预后,观察组上述各项指标水平均显著低于对照组(P<0.05)。干预前,两组SAS、SDS、SF-36评分比较,差异均无统计学意义(P>0.05);干预后,观察组SAS及SDS评分显著低于对照组(P<0.05),SF-36评分显著高于对照组(P<0.05)。观察干预后治疗依从率为95.0%,显著高于对照组的77.5%(P<0.05)。结论综合性护理干预可有助于改善早期慢性肾衰患者肾功能,减轻临床症状及焦虑抑郁情绪,提高患者生活质量与治疗依从性。

Objective To investigate the value of comprehensive nursing intervention in patients with early chronic renal failure treated by colonic dialysis. Methods Eighty patients with early chronic renal failure treated in our hospital between June 2013 and April 2015 were selected as study subjects and were randomized into treatment group and control group, with 40 cases in each group. Both groups were treated with colonic dialysis. The control group was given routine nursing intervention, while the treatment group compre- hensive nursing intervention. The percentage of symptom relief was compared between the two groups. Serum creatinine （SCr）, blood urea nitrogen （BUN） and serum uric acid （UA） were evaluated to evaluate the renal function. The Self-rating Anxiety Scale （SAS）, Self-rating Depression Scale （SDS） and SF-36 health survey short form （SF-36） were used to evaluate the status of anxiety and depression and quality of life. Treatment compliance in the two groups was analyzed. Results After the intervention, in the treatment group, the scores of soreness and weakness of waist and knees （1.23±0.10）, nausea and vomiting （1.09±0119）, fatigue （1.84±0.17）, abdominal distension （1.10±0.24）, anorexia （1.45±0.11 ）, edema （1.24±0.21） and total symptom score （6.29±0.27） were lower than those in control group （P 〈 0.05）. After the intervention, in treatment group, the levels of SCr （140.48±1.94） μmol/L, BUN （6.42± 1.57） mmol/L and UA （340.25±1.65） μmol/L were significantly lower than those in the control group （P 〈 0.05）. In the treatment group, the SAS score （23.18±1.06） and SDS score （25.19±1.07） were lower than those in control group, while SF-36 score （120.47± 1.52） was significantly higher （P 〈 0.05）. After the intervention, the treatment compliance rate in treatment group （95.0%） was significantly higher than that in control group （77.5%） （P 〈 0.05）. Conclusion Comprehensive nursing intervention can significantly improve renal function in patients with early chronic renal failure, relieve clinical symptoms, anxiety and depression, and improve the quality of life and treatment compliance. It is has great Clinical potential.