预见性护理在连续性血液净化患者中的应用

Application of predictive nursing in patients with continuous blood purification

目的 探讨预见性护理在连续性血液净化(CBP)患者中的应用效果。方法 选择2016年6月至2018年6月于我院行CBP的患者82例为研究对象,随机将其分为观察组40例和对照组42例。对照组予以常规护理,观察组在此基础上增加预见性护理。比较两组患者并发症和不良事件发生率,评估两组干预前与干预后1个月凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、急性生理与慢性健康评分(APACHEⅡ),比较两组干预后1个月生活质量健康状况问卷量表(SF-36)评分。结果 两组导管内凝血、意外拔管发生率比较差异无统计学意义(P>0.05),观察组感染、低血压、滤器凝血发生率均低于对照组(P<0.05)。干预后1个月,观察组PT,APACHEⅡ得分低于对照组(P<0.05);APTT,TT高于对照组(P<0.05);SF-36量表中社会功能、躯体功能、躯体疼痛、生命力、总体健康维度得分高于对照组(P<0.05);两组情感角色、心理健康、躯体角色维度得分比较差异无统计学意义(P>0.05)。结论 在CBP患者中应用预见性护理可积极预防并发症,改善凝血功能、生活质量和健康状况。

Objective To explore the application effect of predictive nursing in patients with continuous blood purification(CBP). Methods To select 82 patients who underwent CBP in our hospital from June 2016 to June 2018 as the study subjects. They were randomly assigned to observation group with 40 patients and control group with 42 patients. Patients in the control group received routine nursing, while patients in the observation group were given predictive nursing on this basis. The incidence of complications and adverse events were compared between the two groups. The prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), and acute physiology and chronic health evaluation (APACHEⅡ) scores of the two groups before and after 1 month of intervention were compared. Besides, we also compared the scores of 36-item short form survey(SF-36), the questionnaire to investigate the quality of life and health status, at 1 month after the intervention. Results There was no significant statistical difference in the incidence of intraductal coagulation and accidental extubation between the two groups( P >0.05).The incidence of infection, hypotension and filter coagulation in the observation group were lower than those in the control group( P <0.05). At 1 month after the intervention, the PT and APACHE II scores of the observation group were lower than those of the control group( P <0.05). The APTT and TT were higher than those of the control group( P <0.05). The social function, physical function, physical pain, vitality, and overall health dimension scores of the SF-36 scale were higher than those of the control group( P <0.05). There was no significant statistical difference in the scores of emotional role, mental health, and physical role between the two groups( P >0.05). Conclusion Applying predictive nursing in patients with CBP can prevent complications actively. In addition, it also can improve coagulation function, quality of life and health status of the patients.