基于移动医疗模式下的精准管理在老年血液透析患者中的应用

Application of precise management based on mobile medical model in elderly hemodialysis patients

目的探讨移动医疗模式下的精准管理在老年血液透析患者中的应用效果。方法采用便利抽样法,选取2020年5—12月在郑州大学第一附属医院就诊的158例老年血液透析患者为研究对象,按照随机数字表法将患者分为对照组和观察组,各79例。对照组采取常规血液透析护理管理,观察组在对照组基础上采用基于移动医疗模式的精准管理。比较两组患者营养相关实验室指标、改良主观全面营养评估(SGA)得分、人体成分及透析低血压发生率。结果干预后观察组前白蛋白、白蛋白、身体细胞量、去脂体重均高于对照组,血磷、改良SGA得分及浮肿指数均低于对照组,差异有统计学意义(P<0.05)。观察组干预后前白蛋白、白蛋白、身体细胞量、去脂体重均较干预前升高,血磷、改良SGA得分及浮肿指数均较干预前降低,差异有统计学意义(P<0.05)。观察组和对照组透析低血压发生率分别为6.01%(171/2844)和13.68%(389/2844),差异有统计学意义(χ^(2)=94.132,P<0.01)。结论基于移动医疗模式下的精准管理可以有效改善老年血液透析患者营养水平,提高干体重和液体管理效率。

Objective To explore the application effect of precise management based on mobile medical model in elderly hemodialysis patients.Methods Using the convenient sampling method,a total of 158 elderly hemodialysis patients who were treated in the First Affiliated Hospital of Zhengzhou University from May to December 2020 were selected as the research objects.According to the random number table method,they were randomly divided into the control group and the observation group,with 79 cases in each group.The control group adopted routine hemodialysis nursing management,while the observation group adopted the precise management based on mobile medical mode on the basis of the control group.The nutrition related laboratory indexes,modified Subjective Global Assessment(SGA)score,body composition and the incidence of dialysis hypotension were compared between the two groups.Results After the intervention,prealbumin,albumin,body cell mass and fat free body weight in the observation group were higher than those in the control group,and blood phosphorus,modified SGA score and edema index were lower than those in the control group,and the differences were statistically significant(P<0.05).Prealbumin,albumin,body cell mass and fat free body weight in the observation group after intervention were higher than those before intervention,and blood phosphorus,modified SGA score and edema index were lower than those before intervention,and the differences were statistically significant(P<0.05).The incidence of dialysis hypotension in the observation group and the control group were respectively 6.01%(171/2844)and 13.68%(389/2844),and the differences were statistically significant(χ^(2)=94.132,P<0.01).Conclusions Precise management based on mobile medical mode can effectively improve the nutritional level of elderly hemodialysis patients and improve the efficiency of dry weight and fluid management.