血液透析并发恶性肿瘤患者的预防与护理
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摘要
目的探讨血液透析并发恶性肿瘤患者的预防与护理措施。方法选取2009年1月至2013年1月于海南省中医院消毒供应中心进行血液透析患者540例,按随机数字表法分为两组:常规护理组(270例)结合临床治疗进行置管处的清理消毒,注意患者的各项生命指征等常规护理,综合护理组(270例)在常规护理基础上进行心理护理、临床护理以及生活饮食指导等综合预防与护理。观察两组患者各项临床指标并进行对比分析。结果 540例患者中,7.2%(39/540)的患者在血液透析后出现恶性肿瘤;泌尿系统并发的恶性肿瘤发生率最高,为35.9%;综合护理组有焦虑情绪的为4例,其中死亡2例(16.67%),回归社会的8例;常规护理组有焦虑情绪的20例,其中死亡12例(60.00%),回归社会的7例,两组间比较差异有统计学意义(P<0.05)。结论综合预防与护理能有效改善血液透析并发恶性肿瘤后的疗效,提高患者生活质量,降低病死率。
Objective To explore the method and effect of the prevention of malignant tumor in hemodialysis patients as well as the corresponding nursing care. Methods A total of 540 case of hemodialysis admitted in Disinfection Supply Center of Haikou Traditional Chinese Medicine Hospital from Jan. 2009 to Jan. 2013 were divided into 2 groups according to the random number table method. Patients in the routine nursing group( 270 cases) were just given routine nursing( catheter indwelling point disinfection,monitor on patients' vital signs),while patients in the comprehensive nursing group were given comprehensive nursing and prevention intervention( psychological nursing,clinical nursing and diet guidance) basing on the routine nursing. Clinical indexes of patients in two groups were compared. Results Among all the patients,39( 7. 2%) patients were found with malignant tumor after hemodialysis,and the highest incidence was 35. 9%found in urinary system. The comprehensive nursing group had 4 cases of anxiety,including 2 cases of death( 16. 67%),besides,8 cases returned to society; while the routine nursing group had 20 cases of anxiety,including 12 cases of death( 60. 00%),besides,7 cases returned to society,the differences were statistically significant between the two groups( P < 0. 05). Conclusion Comprehensive prevention and nursing intervention may effectively improve the curative effect of hemodialysis patients complicated by malignant tumor and the patients' quality of life,and reduce the fatality rate.
Objective To explore the method and effect of the prevention of malignant tumor in hemodialysis patients as well as the corresponding nursing care. Methods A total of 540 case of hemodialysis admitted in Disinfection Supply Center of Haikou Traditional Chinese Medicine Hospital from Jan. 2009 to Jan. 2013 were divided into 2 groups according to the random number table method. Patients in the routine nursing group( 270 cases) were just given routine nursing( catheter indwelling point disinfection,monitor on patients' vital signs),while patients in the comprehensive nursing group were given comprehensive nursing and prevention intervention( psychological nursing,clinical nursing and diet guidance) basing on the routine nursing. Clinical indexes of patients in two groups were compared. Results Among all the patients,39( 7. 2%) patients were found with malignant tumor after hemodialysis,and the highest incidence was 35. 9%found in urinary system. The comprehensive nursing group had 4 cases of anxiety,including 2 cases of death( 16. 67%),besides,8 cases returned to society; while the routine nursing group had 20 cases of anxiety,including 12 cases of death( 60. 00%),besides,7 cases returned to society,the differences were statistically significant between the two groups( P < 0. 05). Conclusion Comprehensive prevention and nursing intervention may effectively improve the curative effect of hemodialysis patients complicated by malignant tumor and the patients' quality of life,and reduce the fatality rate.
引文
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[11]安坤.血液透析和持续不卧床腹膜透析患者恶性肿瘤发病率对比分析[J].中国医药导报,2010,7(31):37-38.
[12]刘雁凌,刘丹,叶艳,等.人性化护理干预在尿毒症并发左心衰患者血液透析中的应用[J].中国医药导刊,2012,14(5):890-893.
[13]呼延小媛,张瑞芹,邢春光.1例高龄慢性肾功能不全患者行高位结肠透析的护理体会[J].中国医药导刊,2010,12(4):425-428.
[14]陈筱涛,王益芳,欧秋娟.血液透析患者肿瘤发生的诊断分析[J].实用心脑肺血管病杂志,2010,18(8):1132-1133.
[15]赵敬茹,梁海君,于金秋,等.持续性不卧床腹膜透析相关性腹膜炎的发病原因及护理对策[J].中国医药导刊,2012,14(1):124-125.
[2]张爱华,朱宁,孙玲华,等.腹膜透析患者和血液透析患者生活质量的纵向变化[J].中国现代医学杂志,2009,16(2):261-266.
[3]周懿君,倪兆慧,朱铭力,等.肾脏替代治疗患者长期随访中恶性肿瘤发生情况分析[J].中国微循环,2010,12(5):307-317.
[4]张广钰.尿毒症患者并发胃肠道恶性肿瘤的治疗体会[J].实用医学杂志,2011,27(24):4508-4509.
[5]姜埃利,马腾骧.肾衰长期血液透析肾囊肿与肾肿瘤的发生[J].中华肿瘤杂志,2010,17(3):202-204.
[6]陈光耀,姚许平,陈跃英,等.肾移植后并发恶性肿瘤的临床分析[J].临床泌尿外科杂志,2010,18(3):144-145.
[7]徐小明,张岩,徐自强,等.肾移植受者并发恶性肿瘤34例临床分析[J/CD].中华移植杂志:电子版,2012,6(2):97-104.
[8]马永文,王东文,马韶华,等.肾移植术后恶性肿瘤的临床分析[J].实用医技杂志,2011,18(8):793-794.
[9]张怡玲,尹永红,赵久阳.透析患者并发恶性肿瘤的临床分析[J].大连医科大学学报,2010,32(5):555-568.
[10]周文华,王关乔,杨爱华.维持性血液透析患者恶性肿瘤的发生情况[J].现代实用医学,2010,22(12):1340-1341.
[11]安坤.血液透析和持续不卧床腹膜透析患者恶性肿瘤发病率对比分析[J].中国医药导报,2010,7(31):37-38.
[12]刘雁凌,刘丹,叶艳,等.人性化护理干预在尿毒症并发左心衰患者血液透析中的应用[J].中国医药导刊,2012,14(5):890-893.
[13]呼延小媛,张瑞芹,邢春光.1例高龄慢性肾功能不全患者行高位结肠透析的护理体会[J].中国医药导刊,2010,12(4):425-428.
[14]陈筱涛,王益芳,欧秋娟.血液透析患者肿瘤发生的诊断分析[J].实用心脑肺血管病杂志,2010,18(8):1132-1133.
[15]赵敬茹,梁海君,于金秋,等.持续性不卧床腹膜透析相关性腹膜炎的发病原因及护理对策[J].中国医药导刊,2012,14(1):124-125.