围血液透析期抗凝护理用于血液透析效果分析

Effect of Anticoagulant Nursing During Perihemodialysis Period on Hemodialysis

目的分析围血液透析期抗凝护理用于血液透析的效果。方法收集医院透析中心2022年2月至2023年2月收治的规律性透析患者130例、20280次透析资料。统计凝血事件,逐例逐次分析凝血原因,汇总干预对策,制订围血液透析期护理方案。2023年3月至8月,将同一批患者按透析时间(周一三五,周二四六)抽签分为对照组(46例)和观察组(84例),对照组采用常规护理方案,观察组采用围血液透析期护理方案,比较两组凝血发生情况。结果分组前共发生凝血事件27次,凝血原因包括透析器质量不合格,透析器预冲不充分,患者血流量不足,抗凝剂用量未个性化,患者并发其他原发疾病引起高凝状态,参数设置不合理,停泵时间过长等。观察组采取围血液透析期抗凝护理方案后,均未再发生透析中Ⅱ级及以上凝血事件。对照组共发生22次凝血事件,显著多于观察组的3次(P<0.05)。结论围血液透析期抗凝护理方案包括全面的健康宣教,周到的心理护理,细致的血管通路护理,针对性的凝血干预对策,能有效减少透析中凝血事件的发生,确保患者的透析安全及效果。

Objective To analyze the effect of anticoagulant nursing during the perihemodialysis period on hemodialysis.Methods The data from 130 regular dialysis patients admitted to the hospital dialysis center from February 2022 to February 2023 were collected,with a total of 20280 dialysis sessions.The coagulation events were counted,the causes of coagulation were analyzed case by case,the intervention strategies were summarized,and the nursing plans during the perihemodialysis period were formulated.From March to August 2023,the same batch of patients were randomly divided into the control group(46 cases)and the observation group(84 cases)based on dialysis time(Monday,Wednesday,Friday/Tuesday,Thursday,Saturday).The control group received routine nursing care,while the observation group received perioperative nursing care.The occurrence of coagulation in the two groups was compared.Results A total of 27 coagulation events occurred before grouping,and the causes of coagulation included inadequate dialyzer quality,insufficient dialyzer pre-flushing,insufficient patient blood flow,non-personalized anticoagulant dosage,concurrent hypercoagulability caused by other primary diseases,unreasonable parameter settings,and prolonged pump shutdown time.After adopting the anticoagulant care plan during the perihemodialysis period,the observation group did not experience any grade II or above coagulation events during dialysis.The coagulation events in the control group were 22,which were significantly more than the 3 events in observation group(P<0.05).Conclusion The anticoagulation care plan during hemodialysis includes comprehensive health education,thoughtful psychological care,meticulous vascular access care,targeted coagulation intervention strategies,etc.This plan can effectively reduce the occurrence of coagulation events during dialysis,ensure the safety and effectiveness of dialysis for patients.