心身综合护理应用于尿激酶血液净化中的效果研究

Application of psychosomatic comprehensive nursing to the effect of urokinase blood purification

目的研究心身综合护理应用于血液净化长期置管尿激酶溶栓中的效果。方法选取2016年6月—2018年1月在本院接受维持性血液透析(HD)长期置管的42例患者作为观察资料,将入选患者依据随机数字表法均分为对照组与观察组。对照组采取常规尿激酶溶栓及相关护理,观察组在对照组的基础上给予心身综合护理;观察护理后6个月内透析指标的均值,同时观察两组患者留置导管阻塞情况、滤器的凝血情况、患者心理状态。结果观察组患者的Kt/V、QB、PA、PV各项透析指标均优于对照组(P<0.05);观察组长期留置TCC的阻塞情况较对照组理想,完全堵塞率、不完全堵塞率、需要干预率均低于对照组(P<0.05);观察组透析滤器凝血程度低于对照组(P<0.05);护理后,观察组患者的SAS评分、SDS评分均较前改善(P<0.05),且观察组护理后均优于对照组(P<0.05)。结论心身综合护理能够提高维持血液净化治疗患者的透析疗效,更好地预防长期留置中心静脉导管(TCC)内血栓形成,减轻患者心理压力。

Objective To study the effect of psychosomatic comprehensive nursing on thrombolysis with long-term catheter urokinase in blood purification.Methods 42 patients who received long-term catheterization of maintenance hemodialysis(HD)in our hospital from June 2016 to January 2018 were selected as the observation data.The selected patients were divided into control group and observation group according to the random number method;the control group received routine urokinase thrombolysis and related nursing,and the observation group received psychosomatic comprehensive nursing on the basis of the control group;the mean of dialysis indexes within 6 months after nursing was observed;meanwhile,the obstruction of indwelling catheter,coagulation of filter and patients'mental state were observed.Results The dialysis indexes of Kt/V,QB,PA and PV in the observation group were all better than those in the control group(P<0.05);the long-term indwelling TCC blockage in the observation group was better than that in the control group,and the complete blockage rate,incomplete blockage rate and intervention rate required were all lower than those in the control group(P<0.05);the clotting degree of dialysis filter in the observation group was lower than that in the control group(P<0.05);after nursing,SAS and SDS scores of patients in the observation group were improved by(P<0.05),and those in the observation group were better than those in the control group after nursing(P<0.05).Conclusion Psychosomatic comprehensive nursing can improve the effect of dialysis in patients with maintenance of blood purification treatment,better prevent thrombosis in long-term indwelling central venous catheter(TCC),and reduce the psychological pressure of patients.