应用护理干预降低规律血液透析患者CKD-MBD发生率的影响

Applying nursing intervention to reduce the incidence of CKD-MBD in regular hemodialysis patients

目的:了解护理干预降低规律血液透析患者慢性肾脏病矿物质和骨异常以下称(CKD-MBD)发生率的影响。方法:将我院2017年1月-2019年1月的160例规律血液透析患者,随机分组,对照组给予常规透析护理及健康宣教,饮食指导,采取的形式有分发健康宣教手册,集体健康宣教讲解,责任护士对患者的疑问解答等;试验组开展预防性护理干预,包括进行慢性肾脏病矿物质和骨异常针对性健康教育;收集患者慢性肾脏病矿物质和骨异常发生的风险因素和相关症状;进行低磷优质蛋白饮食管理,选择磷吸收率低的食物,对患者记录的三日饮食给予一对一个体化的健康饮食指导,以提高其依从性;主管护师作为健康宣教员进行小组负责制宣教;干预结束后比较两组满意度;血液透析依从性评分;护理前后焦虑以及抑郁相关心理状态;CKD-MBD相关性生化指标发生率。结果:试验组满意度高于对照组,P<0.05,试验组焦虑以及抑郁相关心理状态评估得分较前下降,P<0.05,血液透析依从性评分高于对照组,P<0.05、CKD-MBD相关性指标发生率低于对照组,P<0.05。结论:规律血液透析患者实施防性护理干预对降低CKD-MBD发生率效果确切。

Objective:To investigate the effect of nursing intervention on the incidence of chronic renal mineral and bone abnormalities(CKD-MBD)in patients with regular hemodialysis.Methods:From January 2017 to January 2019,160 patients with regular hemodialysis in our hospital were randomly divided into groups.The control group was given routine dialysis nursing and health education,dietary guidance,and the forms of health education manual distribution,collective health education explanation,and questions and answers from the responsible nurses.Preventive nursing intervention was carried out in the experimental group,including targeted health education on minerals of chronic kidney disease and bone abnormalities.Risk factors and associated symptoms of chronic kidney mineral and bone abnormalities were collected.Management of low phosphorus and high quality protein diet,selection of food with low phosphorus absorption rate,and one-to-one individualized healthy diet guidance for patients'recorded three-day diet to improve their compliance;As a health promotion teacher,the supervisor nurse carried out group responsibility for publicity and education;The satisfaction of the two groups after intervention,hemodialysis compliance score,mental states related to anxiety and depression before and after nursing care and CKD-MBD correlation biochemical index incidence were compared.Results:The satisfaction of the experimental group was higher than that of the control group(P<0.05),and the scores of anxiety and depression-related psychological states in the experimental group were lower(P<0.05).The scores of hemodialysis compliance were higher than that of the control group,P<0.05,and the incidence of CKD-MBD related indicators was lower than that of the control group(P<0.05).Conclusion:Preventive nursing intervention on regular hemodialysis patients can reduce the incidence of CKD-MBD.