有氧运动护理在维持性血液透析患者中的应用效果

Application effects of aerobic exercise nursing in maintenance hemodialysis patients

目的:观察有氧运动护理在维持性血液透析(MHD)患者中的应用效果。方法:选取2018年3月至2020年2月该院收治的105例MHD患者进行前瞻性研究,按照随机数字表法分为对照组(n=53)和观察组(n=52)。对照组采取常规护理,观察组在对照组基础上采取有氧运动护理,比较两组透析充分性指标[尿素清除指数(KT/V)、尿素下降率(URR)]水平、钙磷水平、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]评分、睡眠质量[匹兹堡睡眠质量指数量表(PSQI)]评分及并发症发生率。结果:观察组URR、KT/V水平均高于对照组,差异有统计学意义(P<0.05);观察组血磷水平低于对照组,差异有统计学意义(P<0.05);两组血钙水平比较,差异无统计学意义(P>0.05);观察组PSQI、SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为7.69%,低于对照组的22.64%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采取有氧运动护理,可提高MHD患者,提高透析充分性,改善患者负面情绪,提高睡眠质量,且不会引起钙磷代谢紊乱,降低并发症发生率,其效果优于单纯常规护理。

Objective: To observe application effects of aerobic exercise nursing in maintenance hemodialysis(MHD) patients. Methods: 105MHD patients admitted to our hospital from March 2018 to February 2020 were selected for the prospective study, and were divided into control group(n=53)and observation group(n=52) according to random number table method. The control group received routine nursing, while the observation group was given the aerobic exercise nursing on the basis of that of the control group. The levels of dialysis adequacy indicators [urea clearance index(KT/V), urea reduction rate(URR)], the calcium and phosphorus level, the negative emotion score [self-rating anxiety scale(SAS), self-rating depression scale(SDS)], the sleep quality [Pittsburgh sleep quality index(PSQI)] score, and the incidence of complications were compared between the two groups. Results: The levels of URR and KT/V in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). The MNA score of the observation group was higher than that of the control group, the serum phosphorus level was lower than that of the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the blood calcium level between the two groups(P>0.05). The PSQI, SAS and SDS scores of the observation group were lower than those of the control group, and the differences were statistically significant(P<0.05). Further, the incidence of complications in the observation group was 7.69%, which was lower than 22.64% in the control group, and the difference was statistically significant(P<0.05).Conclusions: Aerobic exercise nursing on the basis of the routine nursing can improve the dialysis adequacy of the MHD patients, improve the patients’ negative emotions, improve the sleep quality without causing calcium and phosphorus metabolism disorders, and reduce the incidence of complications.Moreover, it is superior to single routine nursing.