医院社区一体化管理在慢性肾功能不全血液透析中的应用

Application of hospital community integrated management in chronic renal insufficiency hemodialysis

目的研究分析医院社区一体化管理对慢性肾功能不全维持性血液透析患者自我护理能力的影响。方法选取2020年6月-2022年10月驻马店市中心医院收治的116例慢性肾功能不全行血液透析滤过治疗的患者,随机分组,对照组(58例)透析期间接受常规透析护理模式,研究组(58例)接受医院社区一体化管理。比较两组血清学指标、营养指标、自我管理能力水平、并发症和不良事件。结果干预后研究组患者血清β_(2)-微球蛋白(β_(2)-MG)、尿素氮(BUN)、甲状旁腺激素(PTH)、血肌酐(Scr)低于对照组,血清前白蛋白(PA)、血红蛋白(Hb)、白蛋白(Alb)高于对照组;干预后研究组患者自我管理能力测定量表(ESCA)中自我护理、问题解决、伙伴关系、情绪处理评分较对照组高;研究组治疗期间并发症和不良事件少于对照组(P<0.05)。结论医院社区一体化管理能增强慢性肾功能不全维持性血液透析患者自护能力,促进内毒素排出体外,改善机体营养状态,且并发症和不良事件少。

Objective To analyze the effect of hospital community integrated management on self-care ability of maintenance hemodialysis patients with chronic renal insufficiency.Methods 116 patients with chronic renal function who underwent hemodiafiltration treatment in Zhumadian Central Hospital from June 2020 to October 2022 were selected and randomized.The control group(58cases)received routine dialysis care during dialysis,and the study group(58 cases)received the integrated management of the hospital.The serological indicators,nutritional indicators,self-management competence level,complications and adverse events were compared between the two groups.Results After intervention,serum β_(2)-microglobulin(β_(2)-MG),urea nitrogen(BUN),parathyroid hormone(PTH),blood creatinine(Scr)in the study group were lower than those in the control group,and serum prealbumin(PA),hemoglobin(Hb),(Alb),and(Alb)were higher than those in the control group.The scores of self-care,problem solving,partnership and emotional processing on the self-management ability scale(ESCA)in the study group were higher than those in the control group.There were fewer complications and adverse events during treatment in the study group than those in the control group(P<0.05).Conclusion Integrated community management in hospital can enhance the self-care ability of chronic renal insufficiency,promote the discharge of endotoxin,and improve the nutritional status of the body,with fewer complications and adverse events.