翁芝敏等

[摘要] 目的 探讨维持控制护理对终末期肾病血液透析患者生存质量、透析指标的影响。 方法 将80例拟接受血液透析的终末期肾病患者随机分为实验组40例和对照组40例，对照组采用常规护理模式，实验组在对照组基础上采用维持控制理论；干预后1个月对两组患者透析指标、生活质量、抑郁、抑郁情绪进行比较。 结果 干预后1个月实验组尿素降低率、尿素清除指数显著降低，血细胞压积显著升高，与对照组相比差异具有统计学意义（P<0.05）；实验组生活质量显著优于对照组（P<0.05）；实验组SAS、SDS得分均显著低于对照组，两组比较差异亦有统计学意义（P<0.05）。 结论 维持控制护理能够提高血液透析效果，改善患者生活质量，降低焦虑、抑郁等负性情绪，值得临床借鉴。

[关键词] 维持控制护理；终末期肾病；血液透析；生存质量

[中图分类号] R692.5 [文献标识码] B [文章编号] 1673-9701（2015）09-0151-03

Effect of quality life and dialysis index of maintain control nursing care on ESRD patients with hemodialysis

WENG Zhimin1 HUANG Xinxiao1 WANG Suying1 GE Chunqin2

1.Hemodialysis Room，Yuhuan County People's Hospital，Zhejiang，Yuhuan 317600，China；2.Second Clinical Medical College，Zhejiang University of Traditional Chinese Medicine，Hangzhou 310053，China

[Abstract] Objective To explore the effect of quality life and dialysis index of maintain control nursing care on ESRD patients with hemodialysis. Methods All 80 cases of ESRD patients underwent hemodialysis were randomly divided into experimental group 40 cases and control group with 40 cases，control group received routine nursing model， the experimental group on the basis of the control group taken maintaining control theory；1 month after the intervention， two groups of patients， quality life， dialysis index，depression and depressive mood were compared. Results 1 month after the intervention， the experimental group urea rate， urea clearance index significantly decreased， hematocrit increased significantly（P<0.05）；the quality of life of experimental group score of each dimension and total health scores were significantly higher than those in control group （P<0.05）； the experimental group SAS， SDS scores were significantly lower than those in control group （P<0.05）. Conclusion Maintain control of nursing intervention can improve the dialysis effect， improve the life quality of patients， reduce anxiety， depression and other negative emotions， and worth the clinical promotion.

[Key words] Maintain control nursing； End-stage renal disease； Hemodialysis； Quality of life

调查显示[1，2]，我国终末期肾病（end stage renal disease，ESRD）患者发病率约为10/10万人，其中约13%的患者接受透析治疗，而血液透析占透析患者的90%左右。随着选择血液透析治疗的肾功能衰竭患者越来越多，对血液透析质量进行控制、提高血透护理成为临床一项重要的工作。本研究采用维持控制理论，通过建立标准、评价执行情况、及时纠正偏差等措施对血液透析患者进行护理，取得了满意的效果，现报道如下。

1 资料与方法

1.1 一般资料

选择2010年9月～2013年9月来我科接受血液透析的终末期肾病患者80例为研究对象，男47例，女33例；年龄23～78岁，平均（51.4±7.1）岁；其中原发性肾损害者41例，糖尿病肾病患者27例，高血压肾病患者12例。纳入标准[3]：①预计长期在我院行血液透析者；②精神及认知状态良好；③能够独立进行沟通；④取得患者或家属同意，并签署知情同意书。排除标准：①存在智力障碍者；……