两种护理干预方法对血透患者透析充分性影响.docVIP

两种护理干预方法对血透患者透析充分性的影响 　　【摘要】 目的：评估两种护理干预方法对MHD患者（MHD）透析充分性的影响。方法：选取2014年1-9月在笔者所在医院血液净化中心行规律透析、病情稳定、在线尿素清除率监测值（OCM）10 cm），A组穿刺时尽量增加穿刺针间的距离至10 cm以上，但透析中血流量保持不变；B组患者透析中提高血流量，但保持穿刺间距不变。观察两组患者护理干预前后透析充分性的变化（OCM值的变化）。结果：A组患者穿刺间距由（6.67±2.76）cm增至（10.43±2.94）cm后，OCM值由（1.12±0.10）升至（1.43±0.15），差异有统计学意义（t=9.7274，P=0.0000）；B组患者的血流量由（245.42±26.65）ml/min增至（275.00±23.61）ml/min后，OCM值由（1.14±0.12）升至（1.48±0.21），差异有统计学意义（t=7.9844，P=0.0000）。结论：MHD患者通过增加穿刺间距和血流量的护理干预方法是提高其透析充分性的重要因素。 　　【关键词】 透析充分性； 透析血流量； 内瘘穿刺间距； 在线尿素清除率监测 　　中图分类号 R473.5 文献标识码 B 文章编号 1674-6805（2015）14-0081-03 　　Effects of Two Kinds of Nursing Interventions on Maintenance Hemodialysis Adequacy/LIANG Wen.//Chinese and Foreign Medical Research，2015，13（14）：81-83 　　【Abstract】 Objective：To assess the effects of two methods about nursing interventions in maintenance hemodialysis adequacy.Method：62 MHD patients who adopted regular dialysis，in a stable condition and OCM value less than 1.2 in Blood Purification Centre of our hospital from January 2014 to September 2014 were selected.According to arteriovenous fistula puncture pitch，they were divided into the group A for 32 cases（needle spacing ≤10 cm） and the group B（needle spacing 10 cm），the distance between the puncture was increased to more than 10 cm in the group A as far as possible，but the blood flow during hemodialysis remain unchanged，the the blood flow was improved in group B during hemodialysis，but kept the needle spacing.The changes of the dialysis adequacy（change of OCM value） in the two groups before and after nursing intervention were observed.Result：In the group A，after the puncture distance increased from （6.67±2.76）cm to （10.43±2.94）cm，the OCM value increased from （1.12±0.10） to （1.43±0.15），the difference was statistically significant（t=9.7274，P=0.0000）.In the group B，after the blood flow increased from （245.42±26.65）ml/min to （275.00±23.61）ml/min，the OCM value increased from （1.14±0.12） to （1.48±0.21），the difference was statistically significant（t=7.9844，P