重症艾滋病合并急性肾功能衰竭患者血液透析后生存质量分析

Analysis for the survival quality of patients with severe AIDS complicated by acute renal failure during hemodialysis

目的探讨重症艾滋病合并急性肾功能衰竭患者血液透析中的护理干预分析。方法选取92例重症艾滋病合并急性肾功能衰竭患者作为研究对象,将其随机分为2组,每组46例。2组均给予抗人类免疫缺陷病毒(HIV)及血液透析治疗,对照组给予常规病房监护,观察组在对照组基础上给予护理干预,2组均持续护理30 d;评定2组护理前后病情严重程度(APACHEⅡ评分)、心理健康状态(SCL-90评分)、生存质量(HIV/AIDSQOL-46)及生化指标水平(白蛋白、血红蛋白、血肌酐、尿素氮),比较2组护理后机会感染发生情况。结果护理后,观察组APACHEⅡ评分、血肌酐、尿素氮均低于护理前(P<0.01),而SCL-90评分、HIV/AIDSQOL-46评分及白蛋白、血红蛋白均高于护理前,且观察组均优于对照组,差异有统计学意义(P<0.01)。结论重症艾滋病合并急性肾功能衰竭患者血液透析中给予护理干预,能有效改善患者不良心理状态,提高生存质量,并缓解病情。

Objective To investigate the nursing intervention effects for patients with severe AIDS complicated by acute renal failure(ARF)during hemodialysis.Methods A total of 92 patients with severe AIDS complicated by acute renal failure were randomly divided into two groups,with 46 cases in each group.The patients in both groups were treated by anti HIV virus drugs and hemodialysis,however,the patients in control group,on the basis of control group,were treated by nursing intervention,with a treatment course of 30 days for both groups.The severity of illness(APACHEⅡscore),mental health status(SCL-90 score),quality of life(HIV/AIDSQOL-46)and biochemical indexes including albumin,hemoglobin,serum creatinine and urea nitrogen before and after nursing were observed and compared between the two groups.Moreover the incidence of opportunistic infection after nursing was laso observed and compared between the two groups.Results After nursing,the APACHEⅡscores,serum levels of creatinine and urea nitrogen in observation group were significantly lower than those before nursing(P<0.01),however,the SCL-90 scores,HIV/AIDSQOL-46 scores,the levels of albumin and hemoglobin in observation group were significantly higher than those before nursing,moreover,which in observation group were superior to those in control group(P<0.01).Conclusion The nursing intervention of patients with severe AIDS complicated by acute renal failure during hemodialysis can effectively improve the poor psychological state,improve the life quality of patients and alleviate the illness condition.