Objective To investigate the current status of frailty in patients on maintenance hemodialysis(MHD),and explore the correlation of frailty with anxiety and depression.Methods General information,clinical data and blood biochemical data of 101 cases who underwent MHD in Department of Nephrology,Shunde Hospital Affiliated to Jinan University from January 2023 to January 2024 were collected.FRAIL scale was applied to evaluate the frailty of the patients,and they were accordingly classified into frailty group and non-frailty group(including pre-frail and non-frail participants).Anxiety and depression were evaluated by GAD-7 and PHQ-9 scale.Univariate analysis and logistic regression were used to explore the association of frailty with anxiety,depression and other possible influencing factors.Results Among the 101 cases,29 cases(28.71%)were includedin frailty group and 72 cases(71.29%)in non-frailty group.There were 42 patients with depression(41.58%)and 25 with anxiety(24.75%).In the frailty group,the prevalence of depression was 65.52%and that of anxiety 55.17%.There were significant differences in age,grip strength,exercise,stroke and coronary heart disease,anxiety and depression,ferritin and CRP between the two groups(P＜0.01).Multivariate regression analysis showed that depression,anxi-ety,no exercise,stroke and high ferritin concentration were independent risk factors for frailty in MHD patients(P＜0.05).Conclusion In patients on MHD,frailty is closely associated with depression,anxiety,and lack of exercise,and stroke as well as high ferritin concentration are independent risk factors for frailty.

Objective To investigate the correlation between serum magnesium(Mg)level and the degree of abdominal aortic calcification(AAC)in maintenance hemodialysis(MHD)patients.Methods A total of 76 MHD patients admitted to the Shunde Hospital Affiliated to Ji'nan University from January to March 2021 were selected as the subjects of this study.According to the abdominal aortic calcification score(AACs)of the patients,all patients were divided into group Ⅰ(0 points≤AACs≤4 points),Group Ⅱ(5 points≤AACs≤15 points)and group Ⅲ(AACs≥16 points).With 1.065 mmol/L Mg concentration as the cut-off value,all patients were divided into high Mg level group and low Mg level group.The general clinical data,serum biochemical indexes and AACs scores of all patients were collected.Results There were 36 cases of AAC in MHD patients,accounting for 47.37%.There were significant differences in age,fasting blood glucose,serum albumin(ALB),Mg,serum phosphorus(Pi),serum parathyroid hormone(PTH)level and calcium-phosphorus product comparison among groups Ⅰ,Ⅱ and Ⅲ(P<0.05).The Mg level in group Ⅰ was significantly higher than that in groups Ⅱ and Ⅲ(P<0.05).The Mg level in group Ⅱ was significantly higher than that in group Ⅲ,and the difference was statistically significant(P<0.05).Logistic multivariate regression analysis showed that Mg was the protective factor of AAC and fasting blood glucose was the influencing factor of AAC.Among MHD patients,there were 33 patients in the high Mg level group,including 10 patients with AAC,accounting for 30.30%,43 patients in the low Mg level group,26 patients with AAC,accounting for 60.47%,the difference between groups was statistically significant(P<0.05).The levels of Pi,PTH and product of calcium and phosphorus in high Mg group were lower than those in low Mg group,while the serum potassium(K)level was higher than that in low Mg group,and the difference between groups was statistically significant(P<0.05).The analysis showed that serum Mg concentration was not correlated with age,fasting blood glucose and other data(P>0.05),but was negatively correlated with AAC,Pi,PTH and calcium and phosphorus product(P<0.05),and was positively correlated with K index(P<0.05).Conclusion MHD patients are more likely to develop AAC.Serum Mg concentration is correlated with AAC,Pi,K,calcium-phosphorus product and serum PTH levels to a certain extent.

目的:探讨对慢性肾衰竭(CRF)患者实施基于行动研究法构建的延续护理模式的临床效果.方法:选取76例CRF患者为研究对象,采用随机排列法将其分为对照组和研究组,每组各38例.对照组患者给予常规健康教育指导,研究组给予基于行动研究法构建的延续护理模式干预,两组干预时长均为6个月.比较干预后患者肾功能指标和生存质量改善情况.结果:研究组干预前血肌酐(SCr)、血尿素氮(BUN)和肾小球滤过率(GFR)三项肾功能指标水平与对照组相比,差异无统计学意义(P>0.05);研究组干预后SCr和BUN水平低于对照组,GFR水平高于对照组,差异有统计学意义(P<0.05).研究组干预前生存质量评分与对照组相比无明显区别,差异无统计学意义(P>0.05);研究组干预后生存质量评分高于对照组,差异有统计学意义(P<0.05).结论:对CRF患者实施基于行动研究法构建的延续护理模式有助于提高其生存质量,改善其肾功能指标,临床干预效果显著.

血液透析(hemodialysis, HD)是临床上医治终末期慢性肾脏疾病的重要手段之一,近年来血液透析的患者越来越多,与之相关联的一些并发症发生频率也逐年升高.HD是一个对患者的身体、心理都具有破坏性的应激过程[1-2].它改变了患者的生活方式并对个人的身心健康产生了负面影响.由于HD治疗的长期性,HD患者在治疗中仍存在较多的问题.HD患者缺乏对饮食依从性是对于医疗团队来说存在的最大的问题之一,从而严重影响到治疗效果[3].他们需要掌握正确的饮食结构,合理安排日常食物,保证机体充足的营养.合理饮食是HD患者十分重要且简单易行的方法之一[4-6].而目前HD患者对其日常生活中所需饮食的信息知之甚少.

目的 分析维持性血液透析(MHD)患者开展基于行动研究法的协同护理模式的作用.方法 选择2018年1月—2020年1月收治的80例MHD患者为研究对象,依据组间基本特征具有可比性的原则将其均分成对照组和观察组,对照组予以常规基础血液透析护理,观察组予以基于行动研究法的协同护理干预.比较两组护理前后汉密尔顿焦虑量表(HAMA)得分、汉密尔顿抑郁量表(HAMD)得分、自我管理行为得分以及简明健康调查表(SF-36)得分.结果 护理前,两组患者HAMA以及HAMD得分比较差异无统计学意义(P>0.05);护理后,观察组HAMA以及HAMD得分均低于对照组,组间比较差异有统计学意义(P<0.05).护理前,两组患者自我护理、问题解决、情绪处理以及伙伴关系得分比较差异无统计学意义(P>0.05);护理后,观察组患者在自我护理、问题解决、情绪处理以及伙伴关系方面得分均高于对照组,组间比较差异有统计学意义(P<0.05).护理前,两组患者SF-36得分比较差异无统计学意义(P>0.05);护理后,观察组SF-36得分高于对照组,组间比较差异有统计学意义(P<0.05).结论 MHD患者开展基于行动研究法的协同护理干预,能够改善负性情绪,提升自我管理能力以及生存质量.

Objective Maintenance hemodialysis patients with residual renal function was evaluated and explored related factors. Methods A total of 83 cases of hemodialysis patients treated in our hospital we selected during May 2014 and October 2015, and all patients evaluated 24-hour urine output, 24 hours urine output greater than 100 mL were classified as RRF group, 24-hour urine less than 100 mL were classified as non-RRF group. All patients underwent blood tests, including calcium, phosphorus, serum albumin, hemoglobin and serum parathyroid hormone, metrics calculated glomerular filtration rate and urea clearance correlation coefficient using statistical methods ,changes compare different groups of indicators. Results Phosphorus, serum albumin, hemoglobin and serum parathyroid hormone were associated with glomerular filtration rate; the two groups showed a significant difference between serum phosphate and serum iPTH levels. Conclusion Use 24-hour urine to evaluate residual renal function is simple and convenience; reducing the delay of residual renal function in dialysis patients for the prognosis of patients has a positive meaning.

目的:探究顺反交替穿刺对透析患者穿刺血管的保护作用.方法:选取2013年1月～2014年6月于我院血液净化中心进行血液透析的患者160例,按照穿刺方式分为两组,采用顺反交替穿刺方法的患者80例为观察组,采用常规穿刺法患者80例为对照组,比较两组患者疼痛评分、并发症、穿刺点压迫止血时间.结果:观察组患者疼痛评分为(2.21±0.25)分,对照组患者疼痛评分为(3.45±0.34)分,两组比较差异具有统计学差异;两组患者在穿刺后进行并发症的统计及比较,包括内瘘感染、内瘘狭窄、内瘘闭塞、假性动脉瘤、血流量下降、渗血、血肿,两组比较差异均具有统计学意义;观察组和对照组患者穿刺点压迫止血时间分别为(4.95±1.23) min、(7.45±1.47)min,两组比较差异具有统计学意义.结论:顺反交替穿刺对透析患者穿刺的血管具有保护作用,值得临床推广使用.