综合护理在维持性血液透析合并继发性甲状旁腺功能亢进术后患者中的应用效果观察

Observation of the effect of comprehensive nursing in postoperative patients with maintenance hemodialysis combined with secondary hyperparathyroidism

目的探讨综合护理在维持性血液透析合并继发性甲状旁腺功能亢进(SHPT)术后患者中的应用效果.方法76例维持性血液透析合并SHPT术后患者,随机分为对照组和观察组,各38例.对照组给予常规护理,观察组在对照组基础上联合综合护理.比较两组护理前后的生化指标[血钙、血磷、钙磷乘积及全段甲状旁腺激素(iPTH)]及护理后7 d知晓率及满意度.结果护理后7 d,两组血钙、钙磷乘积水平均高于护理前,血磷及iPTH水平均低于护理前,且观察组血钙水平(2.35±0.19)mmol/L、钙磷乘积(59.87±10.32)均高于对照组的(2.16±0.16)mmol/L、(54.95±9.98),血磷水平(1.21±0.16)mmol/L、iPTH水平(312.17±8.67)pg/ml均低于对照组的(1.54±0.19)mmol/L、(375.45±10.33)pg/ml,差异有统计学意义(P<0.05).观察组护理后7 d对SHPT病因、SHPT危害性、治疗方法的知晓率和对护理方法、护理内容、护理效果的满意度均高于对照组,差异有统计学意义(χ^2=6.514、4.145、6.176、7.710、4.145、4.547,P<0.05).结论综合护理用于维持性血液透析合并SHPT术后患者中能改善其生化指标,提高患者知晓率和满意度,值得推广应用.

Objective To discuss the practical effect of comprehensive nursing in postoperative patients with maintenance hemodialysis combined with secondary hyperparathyroidism(SHPT).Methods A total of 76 postoperative patients undergoing maintenance hemodialysis combined with SHPT were randomly divided into control group and observation group,with 38 cases in each group.The control group received conventional nursing,and the observation group received comprehensive nursing on the basis of the control group.The biochemical parameters[blood calcium,blood phosphorus,calcium-phosphorus product and intact parathyroid hormone(iPTH)]before and after nursing,awareness rate and satisfaction rate after 7 d of nursing were compared between the two groups.Results 7 d after nursing,blood calcium and calcium-phosphorus product of the two groups was higher than that before nursing,blood phosphorus and iPTH was lower than that before nursing.Blood calcium(2.35±0.19)mmol/L and calcium-phosphorus product(59.87±10.32)of the observation group was higher than that of the control group(2.16±0.16)mmol/L and(54.95±9.98),and blood phosphorus(1.21±0.16)mmol/L and iPTH(312.17±8.67)pg/ml was lower than that of the control group(1.54±0.19)mmol/L and(375.45±10.33)pg/ml.The difference was statistically significant(P<0.05).7 d after nursing,the awareness rate of the etiology,harmfulness and treatment of SHPT and the satisfaction of nursing method,nursing content and nursing effect of the observation group was higher than that of the control group,and the difference was statistically significant(χ^2=6.514,4.145,6.176,7.710,4.145,4.547,P<0.05).Conclusion Comprehensive nursing can improve the biochemical parameters,increase the awareness rate and satisfaction rate in postoperative patients with maintenance hemodialysis combined with SHPT.It is worth popularizing and applying.