以专科护士为主导的多学科网络管理在腹膜透析患者中的应用

目的探讨以腹膜透析(PD)专科护士为主导的多学科网络平台管理对PD患者营养状态及腹膜炎发生率的影响。方法采用便利抽样法选取2018年2—8月在河南省人民医院肾内科规律就诊的72例PD患者为研究对象,采用随机数字表法将患者分为对照组和观察组,各36例。对照组采用传统PD管理模式进行管理,观察组采用PD专科护士为主导的多学科网络平台管理模式进行管理,为期6个月。比较两组患者营养指标[包括改良主观全面营养评价法(SGA)、血红蛋白、白蛋白、血磷]和腹膜炎发生率。结果干预后,观察组改良SGA评分、血磷较对照组低,血红蛋白、白蛋白较对照组高,差异有统计学意义(P<0.05);观察组干预后改良SGA评分、血磷较干预前低,血红蛋白、白蛋白较干预前高,差异有统计学意义(P<0.05);6个月观察期内,对照组腹膜炎发生率为0.06(12/216)次/(患者·月),观察组腹膜炎发生率为0.02(4/216)次/(患者·月),观察组低于对照组,差异有统计学意义(χ^2=4.154,P<0.05)。结论以PD专科护士为主导的多学科网络平台管理模式可以有效改善PD患者营养状况,降低患者腹膜炎发生率,为临床更好管理PD患者提供新的思路。

Application of multidisciplinary network management oriented by nurse specialists in peritoneal dialysis patients

Objective To explore the effects of multidisciplinary network management oriented by nurse specialists on nutritional status and peritonitis in peritoneal dialysis(PD)patients.Methods From February to August 2018,a total of 78 PD patients with regular visit in Department of Nephrology of Henan Province People's Hospital were selected as subjects by convenience sampling.All of patients were divided into control group and observation group with the method of random number table,36 cases in each group.Control group carried out the routine PD management model,while observation group implemented the multidisciplinary network management oriented by PD nurse specialists for 6 months.We compared the nutritional indicators[Modified Subjective Global Assessment(SGA),hemoglobin,albumin and phosphate]and incidence of peritonitis of patients between two groups.Results After intervention,the score of modified SGA and phosphate of observation group were lower than those of control group;the hemoglobin and albumin of observation group were higher than those of control group with statistical differences(P<0.05).In observation group,the score of modified SGA and phosphate after intervention were lower than those before intervention;the hemoglobin and albumin after intervention were higher than those before intervention with statistical differences(P<0.05).The incidence of peritonitis of observation group was 0.02(4/216)times a patient·month within 6 months during observation period lower than that[0.06(12/216)times a patient·month]of control group with a statistical difference(χ^2=4.154,P<0.05).Conclusions Multidisciplinary network management model oriented by PD nurse specialists can effectively improve PD patients'nutritional status,incidence of peritonitis which provides a new thinking for clinical management for PD patients.