三维一体延续性护理在糖尿病肾病维持性血液透析患者中的应用

Application of three-dimensional integrated continuous nursing in maintenance hemodialysis patients with diabetic nephropathy

目的探讨三维一体延续性护理在糖尿病肾病维持性血液透析患者中的应用效果。方法选取2018年1月至2019年10月在海丰县彭湃纪念医院肾内科进行维持性血液透析住院治疗的40例糖尿病肾病患者作为研究对象,按照随机数表法将患者分为观察组和对照组各20例。住院期间两组患者给予相同护理方案,出院后,对照组给予常规护理,观察组给予三维一体延续性护理,时间为3个月。护理3个月后,比较两组患者的血糖控制情况和血肌酐、血钾水平、护理满意度及并发症发生情况,并比较两组患者护理前及护理3个月后的生活质量(采用SF-36生活质量量表评价)。结果护理后,观察组和对照组患者的空腹血糖[(6.41±0.23) mmol/L vs (7.35±0.42)mmol/L]、餐后2 h血糖[(7.75±0.53) mmol/L vs (10.11±0.84) mmol/L]、糖化血红蛋白[(6.32±0.21%) vs (7.67±0.35%)]、血肌酐[(274.75±19.24)μmol/L vs (385.7±27.17)μmol/L]及血钾[(4.42±0.42) mmol/L vs (5.47±0.65) mmol/L]水平比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);护理前,两组患者的SF-36生活质量量表评分比较,差异均无统计学意义(P>0.05);护理后,两组患者的生活质量评分明显升高,且观察组患者的角色功能、躯体功能、社会功能和心理功能各项评分明显高于对照组,差异均有统计学意义(P<0.05);护理后,观察组患者的护理总满意率为95.0%,明显高于对照组的70.0%,差异有统计学意义(P<0.05);观察组患者的并发症总发生率为5.0%,明显低于对照组的30.0%,差异有统计学意义(P<0.05)。结论三维一体延续性护理在糖尿病肾病维持性血液透析患者中的应用效果良好,且可有效改善患者的生活质量,降低并发症发生率,患者的满意度高,值得临床推广应用。

Objective To study effect of three-dimensional quality evaluation model in continuous care of patients with diabetic nephropathy and maintenance hemodialysis. Methods A total of 40 patients with diabetic nephropathy, who admitted to Department of Nephrology, Pengpai Memorial Hospital of Haifeng County for maintenance hemodialysis from January 2018 to October 2019 were selected as the study subjects. According to random number table method,the patients were divided into two groups: observation group(20 cases) and control group(20 cases). During the hospitalization, the two groups of patients were given the same care plan. After discharge, the control group was given routine nursing, while the observation group was given three-dimensional continuous nursing, for 3 months. After three months of nursing, the blood glucose control and serum creatinine, potassium levels, nursing satisfaction, complications of the two groups were compared, and the quality of life before and after nursing were compared using the SF-36 quality of life scale. Results After nursing, the blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, blood creatinine and blood potassium of patients in the observation group were(6.41 ± 0.23) mmol/L,(7.75 ± 0.53) mmol/L,(6.32 ±0.21)%,(274.75 ± 19.24) μ mol/L,(4.42 ± 0.42) mmol/L, respectively, which were significantly lower than corresponding(7.35±0.42) mmol/L,(10.11±0.84) mmol/L,(7.67±0.35)%,(385.7±27.17) μmol/L,(5.47±0.65) mmol/L in the the control group(all P<0.05);after nursing, the SF-36 quality of life in both groups was significantly improved, and the scores of role function, physical function, social function and psychological function in the observation group were significantly higher than those in the control group(all P<0.05);after nursing, the total nursing satisfaction rate of the observation group was 95.00%, which was significantly higher than 70.00% of the control group(P<0.05);the total incidence of complications in the observation group was 5.00%, which was significantly lower than 30.00% in the control group(P<0.05). Conclusion The application of three-dimensional integrated continuous nursing in patients with diabetic nephropathy maintenance hemodialysis has a good effect, and can effectively improve the quality of life of patients, reduce the incidence of complications with high patient satisfaction, and it is worthy of clinical promotion and application.