目的 探索适合血液透析患者的系统饮食教育,改善透析患者的钙磷水平,提高患者的营养状况.方法 组建健康饮食教育团队,筛选40例高磷血症维持性血液透析患者,采取责任护士分组管理,通过集体教育、个体化教育的系统饮食教育,干预3个月后,采取自身前后对照研究的方法评估患者营养状况及钙磷代谢变化.结果 3个月后,患者血磷由(2.12±0.31) mmol/L下降到(1.68 ±0.49) mmol/L(P＜0.01),全段甲状旁腺激素由(824.52±588.07) ng/ml下降到(567.61±526.59) ng/ml(P＜0.05).结论 通过集体教育、个体化教育的系统饮食教育,可以提高患者健康饮食知识水平和依从性,改善饮食习惯,减少磷的摄入,血磷水平下降,改善患者的钙磷代谢.
Objective To investigate the effect of shortening the hemodialysis patients′waiting time for treatment on improving the medical condition. Methods A total of 294 hemodialysis patients in our dialysis center were randomly enrolled in the study from January to June, 2013. The patients, enrolled from January to March, received traditional method ( n=150 ) , and the patients, enrolled from April to June received quality control circle method (n=144), using of the method of slip the peak waiting time for treatment. The application of quality control circle was applied in patients′ waiting, pre-diagnosis, on-line and other medical aspect of continuous quality. The time and satisfaction were compared. Results Three months after the intervention, the waiting time of patients shortened 11 minutes compared with before. The satisfaction of patients improved from 80. 00% to 94. 40% in the pre-diagnosis in order, and the difference was statistically significant (χ2 =13. 792, P<0. 05). Conclusions The implementation of slip the peak waiting time for treatment shortened patients′waiting time and make the pre-diagnosis in order. It can not only reduces the incidence of cross infection, but enhance the concept of nursing care-fair and reasonable. Patients satisfaction on nursing work is also significantly improved, so it effectively avoid the accidental events.
目的 探讨使用血管通路记录表指导护士有计划变换穿刺点对透析患者动静脉内瘘维护的影响,为延长透析患者动静脉内瘘使用时间提供依据.方法 选取2009年1月至2011年12月162例患者为对照组,采用常规阶梯式法;2012年1月至2014年12月176例患者为观察组,采取阶梯法设计穿刺位点,为每位患者建立血管通路记录表,绘制内瘘血管穿刺示意图,护士穿刺前结合血管通路记录表评估血管情况,严格按位点顺序变换穿刺点.观察干预前后两组患者发生血栓、动脉瘤、狭窄等不良事件的发生情况.结果 观察组患者发生动脉瘤、内瘘血栓、狭窄等不良事件发生率为13.64％,较对照组低(P＜0.01).结论 使用血管通路记录表指导护士进行内瘘维护,能够明显减少血栓、动脉瘤、狭窄等不良事件的发生,促进内瘘血管均匀扩张,延长内瘘使用时间.
