Effects of Shenkang Injection Combined with Hemodialysis on Dialysis Rate and Nutriture in Patients with Chronic Renal Failure

OBJECTIVE: To explore the effects of Shenkang Injection combined with hemodialysis on dialysis rate and nutriture in patients with chronic renal failure (CRF).METHODS: A total of 110 CRF patients admitted in the hospital from January 2016 to January 2018 were randomly divided into 2 groups.The control group was treated with hemodialysis while the observation group was additionally treated with Shenkang Injection on the treatment basis of the control group.They were treated for 4 weeks and reexamined 1 d after the treatment.Renal function,nutriture,dialysis adequacy,oxidative stress level and inflammatory factor level in the 2 groups were determined before and after the treatment,and traditional Chinese medicine (TCM) syndrome score,dialysis rate within 1 week and incidence of adverse reactions during the treatment were counted before and after the treatment.RESULTS: After the treatment,the levels of serum creatinine (Scr) and urea nitrogen (BUN) in the observation group were lower than those in the control group,and the endogenous creatinine clearance rate (Ccr) was higher than that in the control group (P < 0.05).After the treatment,the nutriture in the observation group was better than that in the control group (P < 0.05).After the treatment,the dialysis rate and time average concentration of urea (TACurea) in the observation group were lower than those in the control group,while the overall urea clearance rate (Kt/V) and protein catabolic rate (PCR) were higher than those in the control group (P < 0.05).After the treatment,the TCM syndrome scores in the observation group was lower than that in the control group (P < 0.05) and the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control,while the level of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the observation group were higher than those in the control group (P < 0.05).After the treatment,the levels of inflammatory factors in the observation group were lower than those in the control group (P < 0.05).No serious adverse reactions occurred in the 2 groups.CONCLUSION: Shenkang Injection combined with hemodialysis for the treatment of CRF can effectively improve clinical symptoms and nutriture,and reduce the dialysis rate.

Effect of peritoneal dialysis on inflammatory factors, nutritional index and renal function in patients with chronic renal failure

Objective:To explore the effect of peritoneal dialysis on inflammatory factors, nutritional index and renal function indexes in patients with chronic renal failure, and to provide help for clinical treatment of patients with chronic renal failure. Methods:80 cases of chronic renal failure patients in our hospital were selected as the study group, given peritoneal dialysis treatment;80 healthy people during the same period in our hospital selected as the normal group. The inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and IL-8], renal function indices [BUN (Urea nitrogen) and SCR (serum creatinine)] and nutritional index [PA (prealbumin), Hb (hemoglobin), ALB (albumin) and TF (Transferrin)] levels were detected in healthy population and patients with chronic renal failure patients before and after treatment of 1 and 30 d, and the relative significance was analyzed. Results:Compared with the normal group, the inflammatory factors (CRP, IL-6, TNF-αand IL-8) and renal function indices (BUN and SCR) of patients with chronic renal failure in study group increased significantly and nutritional indexes (TF, PA and ALB) decreased significantly (P<0.05). The inflammatory factors (CRP, IL-6, TNF-αand IL-8), nutritional index (TF, PA and ALB) and renal function indices (BUN and SCR) of patients with chronic renal failure by peritoneal dialysis in the treatment of 1 d in research group were significantly lower than the level before treatment, and Hb was significantly higher than that before treatment (P<0.05). After 30 d of dialysis, inflammatory factors (CRP, IL-6, TNF-αand IL-8), nutritional index (TF, PA and ALB) and renal function indices (BUN and SCR) decreased further and Hb increased further (P<0.05). Conclusions:Peritoneal dialysis can improve the inflammatory factors levels of patients with chronic renal failure, reduce the renal function index, and can affect the nutritional index of patients, and has important significance in clinical treatment of patients with chronic renal failure.

Effects of alprostadil combined with Bailing Capsule on residual renal function, renal hemodynamics, immune indexes and nutritional status in patients with chronic renal failure

Objective:To investigate the clinical efficacy and safety of alprostadil combined with Bailing Capsule in the treatment of chronic renal failure,and the influence of alprostadil combined with Bailing Capsule on residual renal function,renal hemodynamics,immune indexes and nutritional status.Methods 86 patients with chronic renal failure(CRF)hospitalized in Wuhan integrated traditional Chinese and Western Medicine Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology from January 2018 to June 2019 were selected as the study objects.They were randomly divided into control group and case group with 43 cases in each group.Two groups were given peritoneal dialysis treatment,the control group was given bailing capsule,the case group was given alprostadil injection on the basis of the control group.To observe the clinical effect of the two groups before and after treatment,and the changes of residual renal function,renal hemodynamics,immune index and nutritional status.Results The total effective rate of the case group was 97.68%,higher than 83.73%of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of bun,SCR,GFR,24h urinary protein quantity,resistance index,CRP,IL-6,TNF,CD8+and SGA in the two groups were lower than those before treatment;the levels of renal blood flow,RRF,CD3+,CD4+,ALB,PA,TRF and Hb were higher than those before treatment;moreover,the improvement of serum inflammatory cytokines,residual renal function and renal hemodynamic indexes,immune indexes and nutritional status in the case group were significant The difference was statistically significant(P<0.05).The incidence of adverse reactions in the control group was 16.28%,higher than 6.98%in the case group,with no significant difference(P>0.05).Conclusion Alprostadil combined with Bailing capsule can significantly improve the residual renal function,hemodynamics,immune index,reduce the degree of inflammatory response in patients with chronic renal failure.

Severe mental disorders following anti-retroviral treatment in a patient on peritoneal dialysis: A case report and literature review

BACKGROUND Antiviral drugs are widely used in populations with viral infection caused by immunologic inadequacy.Because these drugs are mainly metabolized by the kidneys,patients with renal failure undergoing renal replacement therapy are prone to drug adverse effects and poisoning.Severe neurotoxicity caused by antiviral drugs is a rare but life-threatening complication.CASE SUMMARY This study reported one male patient on peritoneal dialysis who suffered from severe mental disorders after receiving an overdose of acyclovir and valacyclovir for the treatment of herpes zoster.The literature review suggested that hemodialysis is better than peritoneal dialysis to clear acyclovir from the circulation.The patient died after his consciousness deteriorated despite peritoneal dialysis and continuous blood purification.CONCLUSION This case emphasizes cautiousness when using anti-retroviral drugs in patients with uremia.Hemodialysis is optimal method to remove the drugs.

Mechanical Complications of Peritoneal Dialysis

Introduction: The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. The mechanical complications of peritoneal dialysis (MCPD) are a major cause of the failure of the technique. The aim of the study was to define the prevalence of peritoneal dialysis (PD) mechanical catheter complications, to determine the time and the factors associated with their occurring. Materials and Methods: A retrospective study was conducted between January 2009 and January 2014 at the nephrology, dialysis and renal transplants department of Ibn Sina university hospital in Rabat. We included all patients who were on peritoneal dialysis and presented mechanical complications. These mechanical catheter complications are represented by catheter migration or obstruction, inguinal or umbilical hernias, early and late peritoneal dialysate leakage, subcutaneous cuff extrusion and hemoperitoneum. Results: MCPD were noted in 23 of the 62 patients (37% of cases). Onset time of complications was 24.8 ± 18.9 months [3 - 60 months]. Among these complications, we noted a catheter migration (65.2%), postoperative hematoma (21.7%), cracking or perforation of catheter (17.4%), epiploic aspiration (17.4%), sleeve externalization (17.4%), catheter obstruction (13%), hemoperitoneum (13%), hernia (22%;13% umbilical and 8.7% inguinal), early dialysate leakage (13%), and pleuroperitoneal leakage (8.7%). The average age of our patients was 54.9 ± 15.5 years [21 - 81 years old], with a male predominance and a sex ratio of 2.28. The average body mass index (BMI) was 25.4 kg/m2. Diabetic patients represent 48.7% of our series. In our study, MCPD represent 13% of causes of transfer to hemodialysis (HD). Conclusion: Prevention of MCPD remains crucial. It is based on good patient education on hygiene and handling errors but also periodic retraining of patients and caregivers.

单中心维持性血液透析与腹膜透析患者生存率比较及影响因素

目的 探讨终末期肾脏病(ESRD)患者血液透析(HD)或腹膜透析(PD)治疗的生存差异及影响因素。方法 纳入2016年3月1日—2022年3月1日在我院行HD或PD治疗并长期随访的ESRD患者156例,其中HD 87例(HD组),PD 69例(PD组)。记录患者性别、年龄、体重、血压、尿量、原发病、血红蛋白、白蛋白、N端脑钠肽前体(NT-proBNP)、甲状旁腺激素(PTH)、残余肾功能、血肌酐、血尿素氮,观察终点事件为全因死亡。生存分析采用Kaplan-Meier分析,生存率比较采用log-rank检验。各因素对生存的影响采用多因素Cox回归风险分析。结果 两组患者性别、年龄、体重、尿量、原发病、血压、血红蛋白、白蛋白、NT-proBNP、PTH、残余肾功能、血肌酐、血尿素氮比较差异均无统计学意义(P>0.05)。HD组和PD组中位生存时间分别为36.0月、42.0月;HD组和PD组1、2、3、4、5年生存率分别为87.3%、80.5%、54%、39.1%、34.5%和86.9%、69.6%、55.1%、29%、24.6%。Log-rank检验显示两组患者生存率比较差异无统计学意义(χ^(2)=0.049,P=0.826)。多因素COX回归分析提示年龄、体重、高血压、NT-proBNP及PTH是终末期肾病患者生存率的影响因素(P=0.010、0.004、0.012、0.003、0.006)。年龄、体重、高血压及血红蛋白是HD组患者生存率的影响因素(P=0.002、0.027、0.023、0.011)。年龄、体重、尿量、血红蛋白及PTH是PD组患者生存率的影响因素(P=0.005、0.067、0.009、0.046、0.018)。结论 终末期肾病患者HD和PD治疗5年生存率比较无明显差异,年龄、体重、高血压、NT-proBNP及PTH是维持性透析患者生存率主要影响因素;HD患者年龄、体重、高血压及血红蛋白含量是生存率主要影响因素;而PD患者年龄、体重、尿量、血红蛋白含量及PTH是生存率主要影响因素。

慢性肾功能衰竭腹膜透析患者发生肾性贫血的风险及其预测模型构建

目的探究慢性肾功能衰竭(CRF)腹膜透析患者发生肾性贫血的风险,并建立风险预测模型。方法回顾性分析2018年7月至2021年6月吉安市中心人民医院收治的106例行腹膜透析CRF患者的临床资料,根据肾性贫血发生情况分为肾性贫血组与未发生肾性贫血组,各53例。比较两组肾性贫血相关因子水平[红细胞计数(RBC)、血红蛋白(Hb)、白蛋白(Alb)、C反应蛋白(CRP)、转铁蛋白(TRF)、转铁蛋白饱和度(TSAT)、血清总铁结合力(TIBC)、不饱和铁结合力(UIBC)],Logistic回归分析腹膜透析患者发生肾性贫血的危险因素,建立预测模型并评估其预测效能。结果肾性贫血组RBC、Hb、Alb、CRP、TRF、TSAT、TIBC、UIBC水平均低于未发生肾性贫血组,差异有统计学意义(P<0.05)。Logistic回归分析显示,TRF、TIBC、UIBC是发生肾性贫血的危险因素(P<0.05),ROC曲线显示AUC分别为0.815、0.919和0.826。肾性贫血风险预测模型验证结果显示,74例患者TRF、TIBC、UIBC的准确度为85.1%、86.5%、89.2%。结论TRF、TIBC、UIBC是发生肾性贫血的危险因素,且风险预测模型对肾性贫血发生预测效能较好。

风险防控质控护理在慢性肾衰竭腹膜透析患者中的应用效果

目的:观察风险防控质控护理在慢性肾衰竭(CRF)腹膜透析患者中的应用效果。方法:选取2018年6月至2020年6月该院收治的70例CRF腹膜透析患者进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各35例。对照组实施常规护理,观察组在对照组基础上实施风险防控质控护理。比较两组护理前后营养指标[总蛋白(TP)、血红蛋白(Hb)、白蛋白(ALB)]水平、生命质量[肾脏病生活质量简表(KDQOL-SF)]评分、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]评分,以及并发症发生率。结果:护理后,观察组TP、Hb、ALB水平和KDQOL-SF评分均高于对照组,差异有统计学意义(P<0.05);观察组SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为8.57%(3/35),低于对照组的40.00%(14/35),差异有统计学意义(P<0.05)。结论:风险防控质控护理应用于CRF腹膜透析患者可提高营养指标水平和生命质量评分,降低负性情绪评分和并发症发生率,效果优于常规护理。

Clinical Observastion on 30 Cases of Chronic Renal Failure Trested with Shentekang Capsule(肾特康胶囊) and Peritoneal Dialysis

Objective: To evaluate the effect of Shentekang Capsule (STKC) combined with peritonealdialysis (PD) in treating chronic renal failure (CRF). Methods: With single-blind, parallel control and random method, 60 cases of CRF patients were equally divided into 2 groups: (1 ) STKC group treated with combined therapy of STKC and PD; (2 ) control group treated with PD alone. The course of treatment were 1~ 2 months for both groups. Clinical manifestations, blood urea nitrogen, serum creatinine, total protein and hemoglobin were observed before and after the treatment. Results: Blood urea nitrogen decreased in both groups after treat ment as compared with that before treatment significantly (P< 0. 05), but no obvious difference was found be tween blood urea nitrogen levels of the two groups (P > 0. 05 ). However, levels of serum total protein and hemoglobin of the STKC group after treatment were higher than those of the control group (P < 0. 01 ). Clinical manifestation in STKC group also showed more improvement after treatment than that in the control group.Conclusion: STKC could improve nutritional state and quality of CRF patient's life treated with PD.

4R理念循证路径对慢性肾衰竭腹膜透析患者的应用效果

目的 观察4R理念循证路径对慢性肾衰竭(CRF)腹膜透析患者肾小球滤过率及远期生活质量的影响。方法 前瞻性招募2022年4月至2023年10月郑州大学第一附属医院接受腹膜透析的慢性肾衰竭患者,共84例。通过计算机随机数法简单抽样分组为观察组和常规组,每组42例。常规组接受肾病内科常规护理方式,观察组接受4R理念模式循证护理路径干预,两组持续护理干预2个月。比较两组临床有效率、肾病生活质量短表(KDQOL-SF)、贝克抑郁量表(BDI-Ⅱ)、并发症发生率、患者满意度评分。结果 观察组临床治疗有效率高于对照组(P<0.05)。护理后两组KDQOL-SF量表得分较治疗前升高,且观察组得分高于对照组(P<0.05)。两组护理后BDI-Ⅱ量表得分较护理前降低,观察组BDI-Ⅱ得分低于对照组(P<0.05)。观察组并发症发生率低于对照组(P=0.013)。观察组患者满意度评分(91.17±10.55)高于对照组(84.54±8.54)(P=0.019)。结论 4R理念循证路径可改善CRF腹膜透析患者治疗有效率,提高生活质量及护理满意度,降低不良反应发生率。

腹膜透析CRF患者自我管理行为与心理韧性、社会支持关系

目的:分析腹膜透析(PD)慢性肾衰竭(CRF)患者自我管理行为与心理韧性、社会支持的关系。方法:对行PD的88例CRF患者进行自我管理量表、Connor-Davidsion韧性量表(CD-RISC)、社会支持评定量表(SSRS)调查,分析自我管理行为与心理韧性、社会支持的关系。结果:PD-CRF患者自我管理量表评分与CD-RISC、SSRS评分呈正相关(P<0.05),且心理韧性、社会支持是PD-CRF患者自我管理行为的影响因素(P<0.05)。结论:自我管理行为与心理韧性、社会支持有关,加强社会支持和提高心理韧性有助于提高PD-CRF患者自我管理行为。

渐进减量的腹膜透析患者临床特征分析

目的临床上观察到少量腹膜透析患者可实现足量起始,逐渐减量,并以小剂量(透析剂量≤4 L/d)维持透析,本研究分析该部分患者的临床特点,探讨渐进减量腹膜透析的可行性及安全性。方法筛选2012年1月—2018年12月于西安交通大学医学院第一附属医院腹膜透析中心置管并符合渐进减量至小剂量透析(以≤4 L/d维持6月以上)的患者,排除急性肾损伤、狼疮性肾炎、血管炎、梗阻性肾病患者。收集其基线肾功、尿量,计算基线(定义为透析1月时)、减量前(指减量至4 L/d前),小剂量维持6月后(指≤4 L/d维持6月时)残余肾功能、腹膜透析充分性。结果共19例患者纳入研究,平均年龄(49.87±20.53)岁,女性11例,男性8例,进入透析时的中位估算肾小球滤过率(estimating glomerular filtration rate,eGFR)为6.87(4.98,9.44)ml/(min·1.73m^(2))。慢性肾小球肾炎8例,糖尿病肾病、高血压肾损害、间质性肾炎各3例、IgA肾病/紫癜性肾炎2例。16例患者起始腹膜透析剂量为6 L/d,3例患者起始剂量为8 L/d。减为小剂量(≤4 L/d)的中位时间为5.33(4.57,14.20)透析月,小剂量维持的中位时间为22.17(13.13,45.80)月。基线时残余肾功能为(4.95±2.04)ml/min,减量前残余肾功能为(7.85±2.78)ml/min,较基线升高(F=10.284,P=0.005)。减量前尿量较基线增加(F=7.374,P=0.015)。小剂量透析维持6月后总尿素清除指数(tKt/V)、总肌酐清除率(total creatinine clearance,tCCr)较减量前无明显变化(F=3.436、0.015,P=0.082、0.904)。结论少量慢性肾衰竭患者经足量透析后残余肾功能较前改善,在该部分患者中小幅渐进减少透析剂量至小剂量维持的方法安全有效。

沙库巴曲缬沙坦钠片治疗腹膜透析合并慢性心衰患者的临床研究

目的:沙库巴曲缬沙坦钠片治疗腹膜透析合并慢性心衰患者的临床研究。方法:选取2021年5月—2023年4月收治的60例腹膜透析合并慢性心衰患者为研究对象,随机数字表法分为对照组与治疗组各30例,对照组给予腹膜透析+基础治疗,治疗组给予腹膜透析+沙库巴曲缬沙坦钠片,对比两组疗效、肾功能、心功能及不良反应。结果:治疗组治疗后NT-proBNP、hs-CRP、Scr较对照组低,血钾较对照组高(P<0.05);治疗组治疗后LVEDD、LVESD指标较对照组低(P<0.05);治疗后两组不良反应发生率差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦钠片可改善患者血液指标,改善心功能,且安全性较高。

远程医疗在慢性肾衰竭病人居家自我管理中的应用研究进展

对国内外远程医疗在慢性肾衰竭病人居家自我管理中的应用研究进行综述,包括远程医疗的概念及发展、远程医疗在慢性肾衰竭病人自我管理中的应用方式及应用效果等,以期为加快肾科远程医疗提供参考,完善慢性肾衰竭病人的自我管理方案。

独根固本颗粒基于“补虚泻实”理论治疗慢性肾功能衰竭早期腹膜透析患者的临床效果

目的 探究独根固本颗粒基于“补虚泻实”理论治疗慢性肾功能衰竭(CRF)早期腹膜透析(PD)患者的临床效果及预后。方法 选取2018年7月至2022年2月就诊于威海市中医院肾病科行早期PD的100例CRF患者,根据随机数表法分为对照组50例和观察组50例,对照组行基础治疗,观察组在对照组基础上采用独根固本颗粒治疗,连续治疗1个月。比较两组临床疗效、肾功能、生存质量。结果 观察组临床总有效率(88.00%)高于对照组(66.00%),差异有统计学意义(P <0.05)。治疗后两组肾功能较治疗前显著改善,观察组改善程度显著大于对照组,差异有统计学意义(P <0.05)。治疗后两组生存质量评分较治疗前明显升高,观察组高于对照组,差异有统计学意义(P <0.05)。结论 独根固本颗粒基于“补虚泻实”理论治疗CRF早期PD患者,不仅能够有效改善临床疗效,而且极大程度地保护了残余肾功能,患者生存质量得到提高,该药物值得临床推广应用。

中西合璧,为肾病患者保驾护航--“中西医结合肾病护理”专栏导读

2020年美国肾脏病数据系统(USRDS)数据显示:成人慢性肾脏病(CKD)患病率约15%。我国流行病学调查显示:成年人CKD患病率为13.4%大约有1.3亿人次,且呈上升趋势。据悉全球每年约有500万至1000万人死于肾脏疾病,CKD已经成为继肿瘤、糖尿病、心脑血管疾病后严重威胁全球人类健康的一种疾病。本专栏聚焦中西医结合肾病护理,旨在探讨中西医结合肾病护理新进展,以及延续性护理、信息化技术、中西医特色技术在肾脏病患者护理与管理中的应用、肾病的临床实践与个案报告,分析与总结慢性肾功能衰竭病患者、糖尿病肾病患者、高血压肾病患者、腹膜透析患者与血液透析患者的护理与管理经验,以期为相关研究与临床实践提供参考,促进肾病护理事业发展。

3 d饮食日记结合个性化营养干预在慢性肾衰竭行腹膜透析病人中的应用

目的:探讨3 d饮食日记结合个性化营养干预对腹膜透析治疗的慢性肾衰竭病人的应用效果。方法:便利抽样选择2020年12月—2022年6月于我院行腹膜透析治疗的160例病人为研究对象,采用随机数字表法随机分为试验组和对照组,每组80例。对照组给予常规饮食指导,试验组给予3 d饮食日记结合营养干预护理。持续干预并进行随访6个月。比较两组病人干预前后营养情况、饮食情况、饮食依从情况及并发症情况。结果:干预后,试验组病人血清清蛋白、血红蛋白、体重、体质指数均高于对照组(P均<0.05),血磷、血钾水平均低于对照组(P均<0.05)。两组血钙、三酰甘油水平比较差异无统计学意义(P>0.05);试验组每日能量、蛋白质摄入量高于对照组(P<0.05),钾、磷摄入量低于对照组(P<0.05),钙摄入量两组差异无统计学意义(P>0.05);肾脏病饮食依从行为量表评分高于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:3 d饮食日记结合个性化营养干预可改善病人营养水平,优化饮食摄入,提高病人饮食管理能力,降低并发症风险。

剪切波弹性成像评估腹膜透析患者腹膜硬化程度的应用价值

目的 应用剪切波弹性成像(SWE)评估腹膜透析患者腹膜硬化程度,探讨其临床应用价值。方法 选取我院行持续非卧床腹膜透析(CAPD)患者168例,根据不同腹膜透析时间分为≤3年组71例、3~11年组78例、≥11年组19例,应用常规超声观测各组肠壁、腹膜厚度及回声、有无钙化等,并对其进行超声评分;应用SWE测量肠壁、腹膜杨氏模量平均值(Emean),比较各组超声评分、SWE参数的差异;分析超声评分、SWE参数与透析时间的相关性。结果 ≤3年组、3~11年组、≥11年组超声评分分别为0(0,0)分、4.9(3.5,7.4)分、7.5(5.7,8.9)分;≤3年组、3~11年组、≥11年组肠壁Emean分别为1.0(0,2.0)kPa、9.9(6.3,14.1)kPa、11.9(6.5,18.6)kPa,腹膜Emean分别为2.0(0,3.0)kPa、11.4(6.5,20.9)kPa、20.3(11.0,30.4)kPa;3~11年组、≥11年组超声评分及肠壁、腹膜Emean均高于≤3年组,差异均有统计学意义(均P<0.01);3~11年组与≥11年组上述参数比较差异均无统计学意义。相关性分析显示,超声评分、肠壁Emean、腹膜Emean均与透析时间呈正相关(r=0.468、0.370、0.584,均P<0.05)。结论 SWE可用于评估腹膜透析患者腹膜硬化程度,具有一定的临床应用价值。

1例腹膜透析置管术后切口脂肪液化患者的护理体会

本文总结1例腹膜透析置管术后患者切口脂肪液化的护理经验。护理人员在做好术后切口常规护理的基础上,根据患者病情,采用特色制剂红纱条进行切口的填塞换药,并根据创面愈合情况加用10%氯化钠注射液外敷,同时加强腹膜透析管理、饮食与营养指导、心理护理等干预措施,有助于促进患者创面愈合、预防并发症。

慢性肾衰腹透患者靶强度导引式有氧运动锻炼法对其营养状态的影响分析

目的探讨慢性肾衰竭腹膜透析患者靶强度导引式有氧运动锻炼法对其营养状态的影响。方法选取2021年6月至2022年11月九江市第一人民医院收治的80例慢性肾衰竭腹膜透析患者作为研究对象,按照随机数字表法分为对照组(40例)与试验组(40例),对照组采用腹膜透析常规护理方法,试验组在常规护理方法的基础上联合靶强度导引式有氧运动锻炼法,比较两组患者的营养状态、肌肉营养状态、并发症发生情况以及生活质量。结果干预前,两组患者微营养状态评估(MNA)评分比较,差异无统计学意义(P>0.05);干预后3个月,两组患者MNA评分高于本组干预前,且试验组MNA评分高于对照组,差异有统计学意义(P<0.05)。干预前,两组患者中臂肌围(MAMC)比较,差异无统计学意义(P>0.05);干预后3个月,两组患者MAMC高于本组干预前,且试验组MAMC高于对照组,差异有统计学意义(P<0.05)。试验组患者并发症总发生率低于对照组,差异有统计学意义(P<0.05)。干预前,两组患者生活质量评分比较,差异无统计学意义(P>0.05);干预后3个月,两组患者生活质量评分高于本组干预前,且试验组生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论靶强度导引式有氧运动锻炼法应用于慢性肾衰竭腹膜透析患者中,能够明显改善患者的营养状态,对患者的生活质量也有一定的提高,还能够减少并发症的发生,值得临床应用。