个体化护理在糖尿病肾病血液透析患者治疗中的作用
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摘要
为了探讨个体化护理对糖尿病肾病血液透析患者治疗依从性及心血管并发症的影响,本研究选取86例糖尿病肾病血液透析患者随机分为对照组和实验组各43例,对照组给予常规护理,实验组在常规护理基础上给予患者个体化护理。通过比较两组患者的治疗依从性和心血管并发症发生率,本研究发现实验组患者的治疗依从性得分(86.64±8.21)高于对照组(80.34±10.76),差异有统计学意义(p<0.05);第7～12个月实验组患者的低血压、心力衰竭和心律失常发生率低于对照组,差异有统计学意义(p<0.05)。本研究表明,糖尿病肾病血液透析患者的个体化护理能有效地提高患者的依从性,减少心血管并发症的发生。
To explore the effect of individualized nursing on adherence and cardiovascular complications in hemodialysis patients with diabetic nephropathy, 86 patients with hemodialysis were randomly divided into control group(n=43) and experiment group(n=43). Patients in both control group and experiment group were treated with routine care. Besides, patients in experimental group were also treated with individualized nursing. By comparing the therapeutic adherence and rate of cardiovascular complication between two groups, we found that the treatment adherence score(86.64 ±8.21) in experimental group was higher than that in control group(80.34 ±10.76), the difference was statistically significantce(p<0.05); 7～12 months after intervention, the incidence rate of hypotension, heart failure and arrhythmia in experiment group was lower than that in control group, the difference was statistically significantce(p<0.05). Our research indicated that individualized nursing could effectively improve the treatment adherence and reduce the incidence of cardiovascular complications in patients with diabetic nephropathy hemodialysis
To explore the effect of individualized nursing on adherence and cardiovascular complications in hemodialysis patients with diabetic nephropathy, 86 patients with hemodialysis were randomly divided into control group(n=43) and experiment group(n=43). Patients in both control group and experiment group were treated with routine care. Besides, patients in experimental group were also treated with individualized nursing. By comparing the therapeutic adherence and rate of cardiovascular complication between two groups, we found that the treatment adherence score(86.64 ±8.21) in experimental group was higher than that in control group(80.34 ±10.76), the difference was statistically significantce(p<0.05); 7～12 months after intervention, the incidence rate of hypotension, heart failure and arrhythmia in experiment group was lower than that in control group, the difference was statistically significantce(p<0.05). Our research indicated that individualized nursing could effectively improve the treatment adherence and reduce the incidence of cardiovascular complications in patients with diabetic nephropathy hemodialysis
引文
Afkarian M.,Zelnick L.R.,Hall Y.N.,Heagerty P.J.,Tuttle K.,Weiss N.S.,and de Boer I.H.,2016,Clinical manifestations of kidney disease among US adults with diabetes,1988-2014,JAMA,316(6):602-610
Coca S.G.,Singanamala S.,and Parikh C.R.,2012,Chronic kidney disease after acute kidney injury:a systematic review and meta-analysis,Kidney International,81(5):442-448
Dong B.,2015,Application of sodium hypochlorite in disinfection of hemodialysis machine,Zhongguo Yixue Shebei(China Medical Equipment),12(6):132-134(董斌,2015,次氯酸钠在血液透析机消毒中的应用,中国医学装备,12(6):132-134)
Gou L.,and Ran X.W.,2013,Blood glucose fluctuations and diabetic vascular complications:current evidence and future directions,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes Mellitus),5(1):7-11(苟林,冉兴无,2013,血糖波动与糖尿病血管并发症-目前的证据与未来的研究方向,中国糖尿病杂志,5(1):7-11)
Gou Y.,and Wei D.,2013,Nursing intervention for patients with diabetic nephropathy hemodialysis,Jilin Yixue(Jilin Medical Journal),34(21):4357-4359(苟颖,魏东,2013,糖尿病肾病患者血液透析的护理干预,吉林医学,34(21):4357-4359)
Gross J.L.,de A zevedo M.J.,Silveiro S.P.,Canani L.H.,Caramori M.L.,and Zelmanovitz T.,2005,Diabetic nephropathy:diagnosis,prevention,and treatment,Diabetes Care,28(1):164-176
Keane W.F.,Brenner B.M.,De Z.D.,Grunfeld J.P.,Mcgill J.,and Mitch W.E.,Ribeiro A.B.,Shahinfar S.,Simpson R.L.,Snapinn S.M.,Toto R.,and RENAAL Study Investigators,2003,The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy:the renaal study,Kidney International,63(4):1499-1507
Koroshi A.,2007,Microalbuminuria,is it so important Hippokratia,11(3):105-107
Lewis G.,and Maxwell A.P.,2014,Risk factor control is key in diabetic nephropathy,The Practitioner,258(1768):13-17
Lim A.K.,2014,Diabetic nephropathy-complications and treatment,Int.J.Nephrol.Renovasc.Dis.,7:361-781
Toyoda K.,and Ninomiya T.,2014,Stroke and cerebrovascular diseases in patients with chronic kidney disease,Lancet Neurology,13(8):823-833
Xu C.J.,Tian Y.R.,and Zhang J.J.,2013,Nursing experience of 26patients with final stage diabetic nephropathy,Shiyong Linchuangyixue Zazhi(Journal of Clinical Medicine in Practice),17(6):29-30(徐传建,田远如,张静静,2013,26例终末期糖尿病肾病患者的护理体会,实用临床医药杂志,17(6):29-30)
Zhang F.H.,Mi X.Q.,and Wang C.,2011,Emphasizing safety assessment and management of hemodialysis equipment,Zhongguo Yixue Shebei(China Medical Equipment),8(2):29-33(张飞鸿,宓现强,王聪,2011,血液透析设备急需加强安全性评估与管理,中国医学装备,8(2):29-33)
Zhang Y.,and Huang J.,2013,The development of medical treatment adherence scale for the end-stage renal disease patients with maintenance hemodialysis,Zhongguo Quanke Kexue(Chinese General Practice),16(34):3312-3316(张艳,黄金,2013,终末期肾病维持性血液透析患者治疗依从性量表的编制,中国全科医学,16(34):3312-3316)
Zhuang X.D.,Ye C.S.,and Yue X.R.,2013,Cleaning,disinfection and analysis of fresenius 4008s hemodialysis machine,Zhongguo Yiliao Shebei(China Medical Devices),28(6):132-133(庄旭东,叶昌盛,岳小荣,2013,费森尤斯4008s型血液透析机清洗消毒过程及故障分析,中国医疗设备,28(6):132-133)
Zhuo L.,Zou G.,Li W.,Lu J.,and Ren W.,2013,Prevalence of diabetic nephropathy complicating non-diabetic renal disease among Chinese patients with type 2 diabetes mellitus,European Journal of Medical Research,18(1):1-8
Lin T.,Lin J.,Chen H.F.,and Liang Z.F.,2012,The impaction of individualized nursing intervention to patients with type 2diabetic nephropathy,Huli Shijian Yu Yanjiu(Nursing Practice)and Research,9(12):30-31(林婷,林捷,陈红芳,梁志凤,2012,个体化护理对2型糖尿病肾病患者的影响,护理实践与研究,9(12):30-31)
Tian J.Y.,2015,The qualitative research on the psychological status and nursing needs of patients at the beginning of the hemodialysis,Huli Guanli Zazhi(Journal of Nursing Administration),15(9):623-625(田君叶,2015,血液透析初期患者心理状态及护理需求的质性研究,护理管理杂志,15(9):623-625)
Wang J.L.,and Xu X.Y.,2013,Nutritional status and malnutrition-related factors in elderly hemodialysis patients,Zhongguo Laoni anxue(Chinese Journal of Gerontology),33(13):3064-3065(王金玲,徐晓燕,2013,老年血液透析患者营养状态及营养不良相关因素,中国老年学,33(13):3064-3065)
Coca S.G.,Singanamala S.,and Parikh C.R.,2012,Chronic kidney disease after acute kidney injury:a systematic review and meta-analysis,Kidney International,81(5):442-448
Dong B.,2015,Application of sodium hypochlorite in disinfection of hemodialysis machine,Zhongguo Yixue Shebei(China Medical Equipment),12(6):132-134(董斌,2015,次氯酸钠在血液透析机消毒中的应用,中国医学装备,12(6):132-134)
Gou L.,and Ran X.W.,2013,Blood glucose fluctuations and diabetic vascular complications:current evidence and future directions,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes Mellitus),5(1):7-11(苟林,冉兴无,2013,血糖波动与糖尿病血管并发症-目前的证据与未来的研究方向,中国糖尿病杂志,5(1):7-11)
Gou Y.,and Wei D.,2013,Nursing intervention for patients with diabetic nephropathy hemodialysis,Jilin Yixue(Jilin Medical Journal),34(21):4357-4359(苟颖,魏东,2013,糖尿病肾病患者血液透析的护理干预,吉林医学,34(21):4357-4359)
Gross J.L.,de A zevedo M.J.,Silveiro S.P.,Canani L.H.,Caramori M.L.,and Zelmanovitz T.,2005,Diabetic nephropathy:diagnosis,prevention,and treatment,Diabetes Care,28(1):164-176
Keane W.F.,Brenner B.M.,De Z.D.,Grunfeld J.P.,Mcgill J.,and Mitch W.E.,Ribeiro A.B.,Shahinfar S.,Simpson R.L.,Snapinn S.M.,Toto R.,and RENAAL Study Investigators,2003,The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy:the renaal study,Kidney International,63(4):1499-1507
Koroshi A.,2007,Microalbuminuria,is it so important Hippokratia,11(3):105-107
Lewis G.,and Maxwell A.P.,2014,Risk factor control is key in diabetic nephropathy,The Practitioner,258(1768):13-17
Lim A.K.,2014,Diabetic nephropathy-complications and treatment,Int.J.Nephrol.Renovasc.Dis.,7:361-781
Toyoda K.,and Ninomiya T.,2014,Stroke and cerebrovascular diseases in patients with chronic kidney disease,Lancet Neurology,13(8):823-833
Xu C.J.,Tian Y.R.,and Zhang J.J.,2013,Nursing experience of 26patients with final stage diabetic nephropathy,Shiyong Linchuangyixue Zazhi(Journal of Clinical Medicine in Practice),17(6):29-30(徐传建,田远如,张静静,2013,26例终末期糖尿病肾病患者的护理体会,实用临床医药杂志,17(6):29-30)
Zhang F.H.,Mi X.Q.,and Wang C.,2011,Emphasizing safety assessment and management of hemodialysis equipment,Zhongguo Yixue Shebei(China Medical Equipment),8(2):29-33(张飞鸿,宓现强,王聪,2011,血液透析设备急需加强安全性评估与管理,中国医学装备,8(2):29-33)
Zhang Y.,and Huang J.,2013,The development of medical treatment adherence scale for the end-stage renal disease patients with maintenance hemodialysis,Zhongguo Quanke Kexue(Chinese General Practice),16(34):3312-3316(张艳,黄金,2013,终末期肾病维持性血液透析患者治疗依从性量表的编制,中国全科医学,16(34):3312-3316)
Zhuang X.D.,Ye C.S.,and Yue X.R.,2013,Cleaning,disinfection and analysis of fresenius 4008s hemodialysis machine,Zhongguo Yiliao Shebei(China Medical Devices),28(6):132-133(庄旭东,叶昌盛,岳小荣,2013,费森尤斯4008s型血液透析机清洗消毒过程及故障分析,中国医疗设备,28(6):132-133)
Zhuo L.,Zou G.,Li W.,Lu J.,and Ren W.,2013,Prevalence of diabetic nephropathy complicating non-diabetic renal disease among Chinese patients with type 2 diabetes mellitus,European Journal of Medical Research,18(1):1-8
Lin T.,Lin J.,Chen H.F.,and Liang Z.F.,2012,The impaction of individualized nursing intervention to patients with type 2diabetic nephropathy,Huli Shijian Yu Yanjiu(Nursing Practice)and Research,9(12):30-31(林婷,林捷,陈红芳,梁志凤,2012,个体化护理对2型糖尿病肾病患者的影响,护理实践与研究,9(12):30-31)
Tian J.Y.,2015,The qualitative research on the psychological status and nursing needs of patients at the beginning of the hemodialysis,Huli Guanli Zazhi(Journal of Nursing Administration),15(9):623-625(田君叶,2015,血液透析初期患者心理状态及护理需求的质性研究,护理管理杂志,15(9):623-625)
Wang J.L.,and Xu X.Y.,2013,Nutritional status and malnutrition-related factors in elderly hemodialysis patients,Zhongguo Laoni anxue(Chinese Journal of Gerontology),33(13):3064-3065(王金玲,徐晓燕,2013,老年血液透析患者营养状态及营养不良相关因素,中国老年学,33(13):3064-3065)
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