上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (5): 584-.doi: 10.3969/j.issn.1674-8115.2013.04.014

• 专题报道（临床护理与管理） • 上一篇    下一篇

护理干预对维持性血液透析患者透析充分性的影响

张旻佳, 王咏梅, 贾丽萍   

  1. 上海市交通大学 医学院附属仁济医院血液净化中心, 上海 200001
  • 出版日期:2013-05-28 发布日期:2013-05-28
  • 作者简介:张旻佳（1981—）, 女, 护师, 学士； 电子信箱: minjiaz@126.com。

Effects of nursing intervention on maintenance hemodialysis adequacy

ZHANG Min-jia, WANG Yong-mei, JIA Li-ping   

  1. Blood Purification Center, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
  • Online:2013-05-28 Published:2013-05-28

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摘要：

目的 探讨不同护理干预措施对维持性血液透析患者透析充分性的影响。方法 选择维持性血液透析患者在线尿素清除率监测值 (OCM)<1.2的78例患者，以动静脉内瘘间距10 cm为界分成2组，选用不同的护理干预措施，比较2组患者在护理干预前后OCM值的变化，即透析充分性的变化。结果 A组患者（内瘘间距>10 cm）通过提高血流量[(275±23.61) mL/min和（245.42±26.65）mL/min]，OCM值升高（1.48±0.21和1.14±0.12，P<0.05），相关性分析显示干预前后患者的OCM值与血流量存在显著的相关性；B组患者（内瘘间距≤10 cm）通过增加A-V内瘘间距[(10.43±2.94) cm和（6.67±2.76） cm]，OCM值升高（1.43±0.15和1.12±0.10，P<0.05）。结论 通过提高血流量和增大内瘘间距的护理干预措施能改善维持性血液透析患者的透析充分性。

关键词: 透析充分性, 血流量, 内瘘间距, 在线尿素清除率监测

Abstract:

Objective To investigate the effects of different nursing interventions on dialysis adequacy of patients undergoing maintenance hemodialysis. Methods Seventy-eight patients undergoing maintenance hemodialysis with online clearance monitoring (OCM) rate <1.2 were selected, and were divided into 2 groups based on the internal arteriovenous fistula spacing of 10 cm. Different nursing interventions were performed in two groups, and the OCM rates before and after intervention were observed in two groups. Results Patients in group A (internal fistula spacing >10 cm) treated with an increased blood flow volume from (245±26.65) mL/min to (275±23.61) mL/min were observed to have the elevation of OCM rate from 1.14±0.12 to 1.48±0.21 (P<0.05), and the correlation analysis indicated a significant correlation between increased blood flow and elevated OCM rate. Patients in group B (internal fistula spacing ≤10 cm) treated with an enlargement of internal fistula spacing from (6.67±2.76) cm to (10.43±2.94) cm were observed to have the elevation of OCM rate from 1.12±0.10 to 1.43±0.15 (P<0.05). Conclusion Either increase in blood flow or enlargement in internal fistula spacing can improve the dialysis adequacy of patients undergoing maintenance hemodialysis.

Key words: dialysis adequacy, blood flow volume, internal fistula spacing, online clearance monitoring