以护士为主导多学科参与的分组管理模式在血液透析患者中的应用

目的探讨以护士为主导多学科参与的分组管理模式在血液透析(hemodialysis,HD)患者中的应用效果。方法2015年6-12月,便利抽样法选择在深圳市人民医院血液净化中心门诊规律行HD的238例患者为研究对象,按照随机数字表法将其分为观察组127例和对照组111例,HD期间,对照组患者给予常规护理干预,观察组患者在对照组的基础上采用以护士为主导多学科参与的分组管理模式,观察并比较两组患者干预前后临床症状的改善情况、血清甲状腺旁激素(intact parathyroid hormone,iPTH)及β_2-微球蛋白(β_2-MG)水平、钙磷代谢情况、相关营养指标的达标率及血管通路并发症的发生率。结果干预后,观察组患者临床症状的改善情况、血清iPTH和β_2-MG水平、钙磷代谢情况、相关营养指标的达标率均优于对照组,血管通路并发症的发生率低于对照组,差异均有统计学意义(均P0.05)。结论应用以护士为主导多学科参与的分组管理模式能有效改善HD患者的钙磷代谢紊乱,改善临床症状,降低血管通路并发症的发生风险,值得在临床推广应用。

Application of Nurse Led Group Management Mode in Clinical Nursing of Hemodialysis Patients

Objective To explore the effect of nurse led group management mode in the clinical nursing of hemodialysis (HD)patients.Methods By convenience sampling,238 cases were selected and randomly di-vided into observation group (n =127)and control group (n =1 1 1).The control group applied with conven-tional nursing model during HD,while the observation group was applied with nurse led group manage-ment mode during HD.The clinical symptom before and after nursing,serum iPTH and β2-microglobulin level and calcium phosphate metabolism,relevant nutritional index and vascular access complication were compared between two groups.Results The clinical symptom,serum iPTH,β2-microglobulin level and calcium phosphate metabolism,relevant nutritional index in observation group were better than that of control group,while the incidence rate of vascular access complication was lower than that of control group (all P <0.05).Conclusions Nurse led group management mode can effectively improve the calcium and phosphorus metabolism disorders and clinical symptons,reduce the complications of vascular access,which is worth for clinical applications.