分层分级延续性护理在中青年腹膜透析患者容量状态管理中的应用效果研究

Study on the application effect of hierarchical continuous nursing in volume state management of peritoneal dialysis patients in young and Middle-aged patients

目的:探讨采用分层分级延续性护理模式对接受腹膜透析的中青年慢性肾功能衰竭患者进行容量状态管理的效果。方法:将广西医科大学第一附属医院肾内科收治的140例中青年慢性肾功能衰竭患者随机分为观察组(n=70)与对照组(n=70)。在两组患者住院期间,对其均进行腹膜透析与常规的容量状态管理。在患者居家进行腹膜透析期间,采用分层分级延续性护理模式对观察组患者进行容量状态管理。比较两组患者的容量状态指标(包括收缩压、舒张压、尿量和透析时的超滤量)、肢体水肿的程度、居家腹膜透析患者自我管理能力调查问卷(简称自我管理能力调查问卷)的评分及其生存质量测定量表简表(QOL-BREF)的评分。结果:护理后,观察组患者的收缩压、舒张压、尿量、透析时的超滤量和中重度肢体水肿的发生率均低于对照组患者,其自我管理能力调查问卷的评分和QOL-BREF的评分均高于对照组患者,差异有统计学意义(P<0.05)。结论:采用分层分级延续性护理模式对接受腹膜透析的中青年慢性肾功能衰竭患者进行容量状态管理能显著改善其机体的容量状态,减轻其肢体水肿的程度,提高其自我管理能力和生存质量。

Objective:To explore the effect of volume state management in young and middle-aged patients with chronic renal failure(CRF)receiving peritoneal dialysis(PD)by using a hierarchical continuing nursing model.Methods:140 young and middle-aged patients with CHRONIC renal failure admitted to the Department of Nephrology,the First Affiliated Hospital of Guangxi Medical University were randomly divided into observation group(n=70)and control group(n=70).Peritoneal dialysis and routine volume status management were performed during hospitalization in both groups.During the peritoneal dialysis at home,the patients in the observation group were managed by hierarchical and continuous nursing mode.Volumetric status indicators(including systolic blood pressure,diastolic blood pressure,urine volume,and ultrafiltration during dialysis),degree of limb edema,and scores on the self-management Ability Questionnaire(SELF-management ability Questionnaire)and qOLBREF were compared between the two groups.Results:After nursing,the incidence of systolic blood pressure,diastolic blood pressure,urine volume,ultrafiltration volume during dialysis and moderate to severe limb edema in the observation group were all lower than those in the control group,and the scores of self-management ability questionnaire and QOL-BREF were all higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:The volume state management of young and middle-aged chronic renal failure patients receiving peritoneal dialysis using the hierarchical continuing nursing model can significantly improve their body volume state,reduce the degree of limb edem a,improve their self-management ability and quality of life.