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延续护理在维持性血液透析患者中的应用效果观察 ?

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   【摘要】 目的:探讨延续护理在慢性肾衰竭维持性血液透析患者中的应用效果。方法:选择2018年7月-2019年2月在某医院进行血液透析治疗的60例门诊患者,将其随机分为对照组(n=30)和观察组(n=30),其中对照组进行常规护理,观察组在常规护理的基础上进行延续护理。3个月后对比两组焦虑评分、抑郁评分、生活质量评分。结果:干预前两组SAS评分、SDS评分比较差异无统计学意义(P>0.05),干预后两组SAS评分、SDS评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05);干预前两组生活质量评分比较差异无统计学意义(P>0.05),干预后观察组各项生活质量评分均高于对照组,差异均有统计学意义(P<0.05)。结论:延续护理可有效降低慢性肾衰竭维持性血液透析患者的焦虑、抑郁情绪,显著提高患者的生活质量,值得临床推广。
   【关键词】 延续护理 慢性肾衰竭 维持性血液透析 心理 生活质量
   [Abstract] Objective: To investigate the effect of continuous nursing in patients with chronic renal failure maintenance hemodialysis (MHD). Method: Sixty outpatients who underwent hemodialysis in the internship hospital from July 2018 to February 2019 were selected, and were randomly divided into the control group (n=30) and the observation group (n=30). The control group were given the routine nursing, and the observation group were given the continuous nursing on the basis of the routine nursing. Three months later, the anxiety score, depression score, and quality of life score between the two groups were compared. Result: There was no significant difference in SAS score and SDS score between the two groups before intervention (P>0.05), the SAS score and SDS score of the two groups after intervention were lower than those before intervention, and the observation group was lower than that of the control group,the differences were statistically significant (P<0.05). There was no significant difference in the quality of life scores between the two groups before intervention (P>0.05), and the quality of life scores in the observation group were higher than those in the control group after intervention, the differences were statistically significant (P<0.05). Conclusion: Continuous nursing can effectively reduce the anxiety and depression of patients with chronic renal failure maintenance hemodialysis, and significantly improve the quality of life of patients, which is worthy of clinical promotion.
  
   當今社会肾衰竭发病率越来越高,据统计,巴西每100万人中有518人发展至终末期肾病;欧洲每100万人约有135人发病;中国终末期肾病发病率每100万人约有100人[1]。终末期肾病患者需进行肾脏替代治疗,但因为合适的肾源有限外加费用高昂,大部分患者通常选择血液透析进行治疗。维持性血液透析(maintenance hemodialysis, MHD)是指患者长期进行血液透析,2~3次/周,一般透析时间超过3个月,目的是将毒素排出患者体外,并补充患者所需要的物质,从患者体内除去过量的水分,确保患者体内水、酸碱平衡,电解质平衡[2]。延续护理是指对院外的患者提供优质连续性护理服务,包括医护人员开展的优质护理项目:使用电话随访、家庭回访、微信等方式进行持续随访及指导等[3]。透析患者病情稳定后,除了进行透析治疗的时间以外,其余时间均在院外,所以血液透析患者对延续护理的需求是非常大的[4]。本文选择2018年7月-2019年2月在某医院进行血液透析治疗的符合标准的60例门诊患者作为研究对象,拟探讨延续护理在慢性肾衰竭(MHD)患者中的应用效果,现报告如下。
  1 资料与方法
  1.1 一般资料
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