糖尿病肾病血液透析患者的护理

目的探讨提高糖尿病肾病血液透析患者的生活质量的护理措施,减少患者死亡率。方法总结近年来我科收治的行维持性血液透析的糖尿病肾病患者50例病例,了解影响其生存率和生活质量的因素。结果糖尿病肾病患者普遍存在糖尿病患者多饮多食,而血透患者限制饮水等矛盾,导致患者进水过多,引起体内水潴留,加重高血压,导致心力衰竭;建立内瘘和开始透析时间推迟;建立永久性血管通道难度增大、内瘘易闭塞;透析中并发症较多,影响透析的充分性等因素,使得糖尿病肾病患者生活质量低,死亡率高。结论饮食护理、保护血管通道、正确合理使用胰岛素、加强透析中并发症的监护是提高糖尿病肾病患者生活质量,减少死亡率的关键。

Nursing of diabetic nephropathy patients in hemodialysis

Objective To investigate the nursing methods for improving the life quality of the diabetic nephropathy patients in hemodialysis,and to reduce the mortality of the patients.Methods 50 patients diagnosed as diabetic nephropathy who were treated with hemodialysis in the second department of nephrology in recent years were summarized.The factors affecting their life quality and mortality were reviewed and evaluated.Results There commonly existed in a contradiction in the patients who were diagnosed as diabetic nephropathy.The patients were apt to eat and drink too much,but the treatment of hemodialysis needed a restriction of water uptake.Thereby,it resulted in the hypertension and heart failure caused by water retention,and the retardation of the establishment of fistula and of initiating hemodialysis.In addition,the construction of permanent blood channel became difficult,the fistula was easy to obstruct,and the complications were too many that the sufficiency of hemodialysis and the like factors were affected.These conditions all induced low-life-quality and high mortality.Conclusions The crisis for improving the life quality of diabetic nephropathy patients in hemodialysis and reducing mortality is to maintain the diabetic diet,protect the blood channel,use insulin correctly,and strengthen the monitoring of the complications during hemodialysis.