终末期糖尿病肾病患者在血液透析护理中应用细节管理护理的效果观察

Effect of Detail Management Nursing in Hemodialysis Nursing of Patients with End-stage Diabetic Nephropathy

目的:探讨终末期糖尿病肾病(DN)患者的血液透析护理中应用细节管理护理的效果.方法:选取2020年1月—2022年12月在中国人民解放军联勤保障部队第901医院血液净化中心行血液透析治疗的终末期DN患者60例为观察对象,随机分为对照组和观察组,各30例.对照组应用常规护理,观察组应用细节管理护理.比较两组血糖及营养状态、心理状态、并发症情况、生活质量.结果:护理后,两组空腹血糖、餐后2 h血糖及患者主观整体评估评分低于护理前,观察组体质量指数高于护理前,且观察组均优于对照组,差异有统计学意义(P<0.05);护理后,两组焦虑自评量表、抑郁自评量表评分均低于护理前,观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P=0.010);护理后,两组角色领域、躯体领域、认知领域、社会领域、情绪领域评分均高于护理前,观察组高于对照组,差异有统计学意义(P<0.05).结论:终末期DN患者血液透析护理中应用细节管理护理的效果显著,能有效降低血糖,改善营养状态,减少并发症,调节心态,提高生活质量.

Objective:To investigate the effect of detail management nursing in hemodialysis nursing of patients with end-stage diabetic nephropathy(DN).Methods:A total of sixty patients with end-stage DN who underwent hemodialysis treatment in the Blood Purification Center of the 901 Hospital of Chinese People's Liberation Army Joint Logistic Support Force from January 2020 to December 2022 were selected as the observation objects,and were randomly divided into control group and observation group,with thirty patients in each group.The control group was treated with routine nursing,and the observation group was treated with detailed management nursing.Blood glucose,nutritional status,psychological status,complications and quality of life were compared between the two groups.Results:After nursing,fasting blood glucose,2 h postprandial blood glucose and subjective global assessment scores of the two groups were lower than before nursing,and body mass index of the observation group was higher than before nursing,and the observation group was better than the control group,with statistical significance(P<0.05);after nursing,the scores of self-rating anxiety scale and self-rating depression scale in 2 groups were lower than before nursing,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);the incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P=0.010);after nursing,the scores of role field,body field,cognitive field,social field and emotional field in both groups were higher than before nursing,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion:The application of detail management nursing in hemodialysis nursing of end-stage DN patients has significant effects,which can effectively reduce blood glucose,improve nutritional status,reduce complications,adjust mentality and improve quality of life.