结构化皮肤管理模式对老年维持性血液透析患者带Cuff导管感染的预防效果研究

Effect of structured Skin Management Model on Prevention of Infection with Cuff Catheter in elderly Maintenance Hemodialysis Patients

目的探究结构化皮肤管理模式对老年维持性血液透析患者带Cuff导管感染的预防效果。方法回顾性分析2018年4月至2021年8月于永城市人民医院行血液透析治疗并带有Guff导管的178例老年患者为研究对象,根据时间顺序将2018年4月至2020年1月收治的87例患者为对照组,2020年2月至2021年8月收治的91例患者为改良组,对照组患者接受常规皮肤管理,改良组患者接受结构化皮肤管理模式。比较两组患者的导管感染情况、并发症、非计划性拔管发生率、各时间段导管血流量、透析治疗及护理满意度。结果随访期间,改良组患者的导管感染发生率(2.20%)低于对照组(9.20%),差异有统计学意义(P<0.05);截止随访结束,改良组患者的非计划性拔管率(0.00%)低于对照组(4.60%),差异有统计学意义(P<0.05);两组间导管血栓/纤维蛋白鞘形成与中心静脉狭窄/闭塞发生率差异无统计学意义(P>0.05);干预1个月、干预3个月、干预6个月,改良组患者的导管血流量高于对照组,差异有统计学意义(P<0.05);改良组患者的透析治疗满意度、导管护理满意度、护理满意度高于对照组,差异有统计学意义(P<0.05)。结论结构化皮肤管理模式对接受维持性血液透析治疗的老年患者Cuff导管感染预防效果良好,值得临床借鉴与参考。

Objective To explore the preventive effect of structured skin management model on infection with Cuff catheter in elderly maintenance hemodialysis patients.Methods Retrospective analysis was made on 178 elderly patients with Guff catheter who underwent hemodialysis in Yongcheng People's Hospital from April 2018 to August 2021.According to the time sequence,87 patients who were treated from April 2018 to January 2020 were taken as the control group,91 patients who were treated from February 2020 to August 2021 were taken as the improvement group.The patients in the control group received conventional skin management,and the patients in the improvement group received structured skin management mode.The catheter infection,complications,incidence of unplanned extubation,catheter blood flow,dialysis treatment and nursing satisfaction were compared between the two groups.Results During the follow-up period,the incidence of catheter infection in the improved group(2.20%)was lower than that in the control group(9.20%),with a statistically significant difference(P<0.05);By the end of follow-up,the unplanned extubation rate of patients in the improved group(0.00%)was lower than that in the control group(4.60%),with a statistically significant difference(P<0.05);There was no significant difference in the incidence of catheter thrombosis/fibrin sheath formation and central vein stenosis/occlusion between the two groups(P>0.05);After one month,three months and six months of intervention,the blood flow of catheter in the improved group was higher than that in the control group,with a statistically significant difference(P<0.05);The dialysis treatment satisfaction,catheter nursing satisfaction and nursing satisfaction in the improved group were higher than those in the control group,with a statistically significant difference(P<0.05).Conclusion The structured skin management model has a good effect on the prevention of Cuff catheter infection in elderly patients receiving maintenance hemodialysis,which is worthy of clinical reference.