循证护理结合水化疗法对下肢动脉硬化闭塞症患者介入术后对比剂肾病的预防效果

Preventive effect of evidence-based nursing combined with hydration therapy on contrast-induced nephropathy in patients with peripheral arterial disease after intervention surgery

目的:观察循证护理结合水化疗法对下肢动脉硬化闭塞症(peripheral arterial disease,PAD)患者介入术后对比剂肾病(contrast-induced nephropathy,CIN)的预防效果。方法:选取秦皇岛市第一医院2013年10月至2016年10月收治的行介入手术的130例PAD患者,利用简单随机抽样法,将符合纳入标准的患者随机分为观察组和对照组,各65例。对照组采用常规护理干预措施及水化疗法,观察组在对照组基础上采用循证护理结合水化疗法,比较2组干预效果。结果:观察组CIN发生率为[3.08%(2/65)]低于对照组[12.31%(8/65)],组间差异具有统计学意义(χ2=3.900,P=0.048);观察组干预后血尿素氮(blood urea nitrogen,BUN)、血清肌酐(serum creatinine,SCr)、尿蛋白水平低于对照组,组间差异均具有统计学意义(均P<0.05);观察组健康教育各项评分均高于对照组,组间差异均具有统计学意义(均P<0.05);观察组干预后焦虑自评量表(Self-rating Anxiety Scale,SAS)与抑郁自评量表(Self-rating Depression Scale,SDS)均低于对照组,组间差异均具有统计学意义(P<0.05);观察组预防CIN的发生、定期进行肾功能检测的完全依从率分别为98.46%和100.00%,高于对照组的89.23%和93.85%,组间差异均具有统计学意义(均P<0.05)。结论:循证护理结合水化疗法对PAD患者介入术后CIN的预防效果良好,能有效减少CIN的发生。

Objective:To observe the preventive effect of evidence-based nursing combined with hydration therapy on contrast-induced nephropathy(CIN)in patients with peripheral arterial disease(PAD)after intervention operation.Methods:A total of 130 PAD patients who underwent intervention operation and were admitted to the hospital from October 2013 to October 2016 were enrolled.The patients who met the inclusion criterias were randomly divided into observation group and control group by simple random sampling,with 65 cases in each group.The control group underwent routine nursing interventions and hydration therapy.On this basis,observation group underwent evidence-based nursing combined with hydration therapy further.The intervention effects were compared between the two groups.Results:The incidence of CIN in observation group was lower than that in control group[3.08%(2/65)vs 12.31%(8/65)](χ2=3.900,P=0.048).After intervention,levels of blood urea nitrogen(BUN),serum creatinine(SCr)and urine protein in observation group were lower than those in control group(P<0.05).The scores of health education in observation group were higher than those in control group(P<0.05).After intervention,scores of Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)in observation group were lower than those in control group(P<0.05).The complete compliance rates of prevention CIN and regular renal function test in observation group were 98.46%and 100.00%,respectively,higher than those in control group(89.23%,93.85%)(P<0.05).Conclusion:Evidence-based nursing combined with hydration therapy has a positive preventive effect on CIN in PAD patients after intervention surgery,and can effectively reduce the occurrence of CIN.