预见性护理在连续性血液净化患者中的应用
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摘要
目的探讨预见性护理在连续性血液净化(CBP)患者中的应用效果。方法选择2016年6月至2018年6月于我院行CBP的患者82例为研究对象,随机将其分为观察组40例和对照组42例。对照组予以常规护理,观察组在此基础上增加预见性护理。比较两组患者并发症和不良事件发生率,评估两组干预前与干预后1个月凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、急性生理与慢性健康评分(APACHEⅡ),比较两组干预后1个月生活质量健康状况问卷量表(SF-36)评分。结果两组导管内凝血、意外拔管发生率比较差异无统计学意义(P> 0. 05),观察组感染、低血压、滤器凝血发生率均低于对照组(P <0. 05)。干预后1个月,观察组PT,APACHEⅡ得分低于对照组(P<0. 05); APTT,TT高于对照组(P <0. 05); SF-36量表中社会功能、躯体功能、躯体疼痛、生命力、总体健康维度得分高于对照组(P <0. 05);两组情感角色、心理健康、躯体角色维度得分比较差异无统计学意义(P> 0. 05)。结论在CBP患者中应用预见性护理可积极预防并发症,改善凝血功能、生活质量和健康状况。
Objective To explore the application effect of predictive nursing in patients with continuous blood purification( CBP). Methods To select 82 patients who underwent CBP in our hospital from June 2016 to June 2018 as the study subjects. They were randomly assigned to observation group with 40 patients and control group with 42 patients. Patients in the control group received routine nursing,while patients in the observation group were given predictive nursing on this basis. The incidence of complications and adverse events were compared between the two groups. The prothrombin time( PT),activated partial thromboplastin time( APTT),thrombin time( TT),and acute physiology and chronic health evaluation( APACHE Ⅱ) scores of the two groups before and after 1 month of intervention were compared. Besides,we also compared the scores of 36-item short form survey( SF-36),the questionnaire to investigate the quality of life and health status,at 1 month after the intervention. Results There was no significant statistical difference in the incidence of intraductal coagulation and accidental extubation between the two groups( P > 0. 05). The incidence of infection,hypotension and filter coagulation in the observation group were lower than those in the control group( P < 0. 05). At 1 month after the intervention,the PT and APACHE II scores of the observation group were lower than those of the control group( P < 0. 05). The APTT and TT were higher than those of the control group( P < 0. 05). The social function,physical function,physical pain,vitality,and overall health dimension scores of the SF-36 scale were higher than those of the control group( P < 0. 05). There was no significant statistical difference in the scores of emotional role,mental health,and physical role between the two groups( P> 0. 05). Conclusion Applying predictive nursing in patients with CBP can prevent complications actively. In addition,it also can improve coagulation function,quality of life and health status of the patients.
Objective To explore the application effect of predictive nursing in patients with continuous blood purification( CBP). Methods To select 82 patients who underwent CBP in our hospital from June 2016 to June 2018 as the study subjects. They were randomly assigned to observation group with 40 patients and control group with 42 patients. Patients in the control group received routine nursing,while patients in the observation group were given predictive nursing on this basis. The incidence of complications and adverse events were compared between the two groups. The prothrombin time( PT),activated partial thromboplastin time( APTT),thrombin time( TT),and acute physiology and chronic health evaluation( APACHE Ⅱ) scores of the two groups before and after 1 month of intervention were compared. Besides,we also compared the scores of 36-item short form survey( SF-36),the questionnaire to investigate the quality of life and health status,at 1 month after the intervention. Results There was no significant statistical difference in the incidence of intraductal coagulation and accidental extubation between the two groups( P > 0. 05). The incidence of infection,hypotension and filter coagulation in the observation group were lower than those in the control group( P < 0. 05). At 1 month after the intervention,the PT and APACHE II scores of the observation group were lower than those of the control group( P < 0. 05). The APTT and TT were higher than those of the control group( P < 0. 05). The social function,physical function,physical pain,vitality,and overall health dimension scores of the SF-36 scale were higher than those of the control group( P < 0. 05). There was no significant statistical difference in the scores of emotional role,mental health,and physical role between the two groups( P> 0. 05). Conclusion Applying predictive nursing in patients with CBP can prevent complications actively. In addition,it also can improve coagulation function,quality of life and health status of the patients.
引文
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[7]李九红,黄伶智,任小红,等.维持性血液透析患者症状困扰与睡眠质量和生活质量的相关性研究[J].中国护理管理,2016,16(1):25-29.
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[11]江从兵,曹灵红.CBP联合早期肠内营养治疗SAP合并高脂血症的效果分析[J].重庆医学,2017,46(9):1220-1222.
[12]杨从山,杨毅,黄力维,等.重症医学科连续性肾脏替代治疗应用现况调查分析[J].中华医学杂志,2016,96(39):3151-3155.
[13]马会玲.护理干预对重症胰腺炎连续血液净化治疗期间并发症的预防作用[J].现代消化及介入诊疗,2016,21(6):912-914.
[14]张珂,黄丽璇,吕桂兰.连续性血液净化体外循环静脉壶凝血的危险因素分析及预防措施进展[J].医学研究生学报,2018,31(3):328-332.
[2]张勇,曾维政,王云侠,等.连续性血液净化治疗重症急性胰腺炎合并多器官功能障碍综合征的效果观察[J].临床肝胆病杂志,2016,32(2):320-323.
[3]陈克娇,陈清秀.严重脓毒症患儿行连续血液净化的护理[J].护士进修杂志,2017,32(7):636-638
[4]王轶文.预见性护理干预在血液透析患者中的应用[J].护理实践与研究,2018,15(12):61-62.
[5]马慧,韩玲.预见性护理在预防血液净化导管相关性血流感染中的应用[J].实用临床医药杂志,2018,22(12):30-33.
[6]李秀川.营养风险及急性生理学与慢性健康状况评分与危重症患者预后的关系[J].中国实用护理杂志,2016,32(13):961-964.
[7]李九红,黄伶智,任小红,等.维持性血液透析患者症状困扰与睡眠质量和生活质量的相关性研究[J].中国护理管理,2016,16(1):25-29.
[8]罗勇,吴云来.连续性血液净化在重症监护病房多器官功能障碍综合征患者中的应用效果及对预后的影响[J].医学综述,2018,24(13):2697-2700.
[9]吴秀红.进行血液净化治疗患者的风险隐患与护理对策[J].护理实践与研究,2018,15(23):32-33.
[10]何联义,刘海兰,唐喜宁,等.连续性血液净化对多器官功能障碍综合征患者炎性介质、血流动力和凝血功能的影响[J].中国医学装备,2018,15(8):76-80.
[11]江从兵,曹灵红.CBP联合早期肠内营养治疗SAP合并高脂血症的效果分析[J].重庆医学,2017,46(9):1220-1222.
[12]杨从山,杨毅,黄力维,等.重症医学科连续性肾脏替代治疗应用现况调查分析[J].中华医学杂志,2016,96(39):3151-3155.
[13]马会玲.护理干预对重症胰腺炎连续血液净化治疗期间并发症的预防作用[J].现代消化及介入诊疗,2016,21(6):912-914.
[14]张珂,黄丽璇,吕桂兰.连续性血液净化体外循环静脉壶凝血的危险因素分析及预防措施进展[J].医学研究生学报,2018,31(3):328-332.