Clark护理联合循环管路小组模式在血液透析患者中的应用探索

Application of Clark Nursing Combined with Circulation Pipeline Team Model in Hemodialysis Patients

目的探讨Clark护理联合循环管路小组模式在血液透析患者中应用的临床价值。方法回顾性分析2021年3月至2022年3月我院106例肾功能衰竭患者的临床资料,采用便利抽样方法,遵循自愿原则将接受Clark护理联合循环管路小组护理的患者为研究组(53例),接受常规护理的患者为对照组(53例)。比较两组的医院焦虑抑郁量表(HAD)、纤维蛋白原(FIB)、匹兹堡睡眠质量指数(PSQI)、血清肌酐(Scr)、D二聚体(D-D)、血磷(P)、全段甲状旁腺素(iPTH)、成年人健康自我管理能力测评量表(AHSMARS)、血钙(Ca)、终末期肾病维持性血液透析患者治疗依从性量表(MTAS-ESRD)、血小板(PLT)、透析并发症发生情况及肾脏疾病特异性调查表(KDQ)评分。结果干预前,两组的HAD、FIB、PSQI、P、D-D、AHSMARS、Scr、Ca、iPTH、MTAS-ESRD、PLT、各项KDQ评分差异无统计学意义(P>0.05);干预后,研究组的HAD、FIB、PSQI、P、Scr、Ca、D-D、iPTH、PLT低于对照组(P<0.05),研究组的AHSMARS、MTAS-ESRD、各项KDQ评分(躯体症状、挫折、疲劳、与他人关系)高于对照组(P<0.05)。研究组的透析并发症发生率低于对照组(P<0.05)。结论Clark护理联合循环管路小组护理在血液透析患者中的应用效果良好,能够提高血液代谢产物清除效率与管路安全性,改善患者不良情绪、健康管理能力与依从性,降低体外循环凝血等并发症发生风险,提升生活质量。

Objective To explore the clinical value of Clark nursing combined with circulation group model in hemodialysis.Methods Clinical data of 106 patients with renal failure in our hospital from March 2021 to March 2022 were retrospectively analyzed.Patients receiving Clark care combined circulation pipeline group were set as study group(53 cases),and patients receiving conventional care were set as control group(53 cases).The hospital anxiety and depression scale(HAD),fibrinogen(FIB),Pittsburgh sleep quality index(PSQI),serum creatinine(Scr),D-dimer(D-D),blood phosphorus(P),total parathyroid hormone(iPTH),adult health self-management scale(AHSMARS),blood calcium(Ca),and endgame were compared between the two groups treatment compliance scale(MTAS-ESRD),platelet(PLT),incidence of dialysis complications and renal disease specific questionnaire(KDQ)scores of patients with maintenance hemodialysis for stage renal disease.Results Before intervention,there were no significant differences in the scores of HAD,FIB,PSQI,P,D-D,AHSMARS,Scr,Ca,iPTH,MTAS-ESRD,PLT and KDQ between the two groups(P>0.05);After intervention,HAD,FIB,PSQI,P,Scr,Ca,D-D,iPTH,PLT in the study group were lower than those in the control group(P<0.05),while the levels of AHSMARS,MTAS-ESRD and various KDQ scores(somatic symptoms,frustration,fatigue and relationship with others)in the study group were higher than those in the control group(P<0.05).The incidence of dialysis complications in the study group was lower than that in the control group(P<0.05).Conclusion The application of clark care combined circulation pipeline group care in hemodialysis of patients with renal failure has a good effect,which can improve the efficiency of blood metabolite clearance and pipeline safety,improve patients bad mood,health management ability and compliance,reduce the risk of complications such as extracorporeal circulation coagulation,and improve the quality of life.