张萍??黄岭娥??林小兰

[摘要] 目的 探讨护理安全管理原则的临床路径在血液透析室中的应用效果。 方法 对在2015年10月～2016年9月期间在我院血液透析室治疗的病患72例，随机分为临床路径组，简称路径组（基于护理安全管理原则的临床路径）和对照组（普通常规护理）来对比分析两组患者在心理焦虑度、预后及并发症发生的几率方面存在的差异问题。 结果 路径组的心理焦虑发生概率（22.22%）低于对照组（66.66%）；路径组的三年生存率（69.44%）、五年生存率（50%）均明显高于对照组三年生存率（36.11%）和五年生存率（16.66%）；同时路径组合并并发症的几率（8.33%）也低于对照组（33.33%），以上三组的对比具有统计学意义（P<0.05）。结论 针对在血液透析室就诊的患者应用护理安全管理原则的临床路径可以有效的缓解病患的心理焦虑，害怕等负面情绪，促进患者与医生的积极交流与合作，从而对改善患者的健康状况，提升治疗效果，有效减少并发症的发生有正性效用。因此在临床上有较高的推广价值。

[关键词] 护理安全管理原则；临床路径；血液透析

[中图分类号] R473.5 [文献标识码] A [文章编号] 2095-0616（2017）11-140-03

Application of nursing safety management principle in hemodialysis room

ZHANG Ping HUANG Ling'e LIN Xiaolan

Jiaoling County People's Hospital， Guangdong， Jiaoling 514199， China

[Abstract] Objective To explore the clinical effect on nursi ng safety management principle in hemodialysis room. Methods 70 patients treated in the hemodialysis room from October 2015 to September 2016 were randomly divided into the clinical path group abbreviated as path group （clinical path based on the principle of nursing safety management） and the control group （general routine care）. The psychological anxiety， prognosis， and the probability of occurrence of the two groups of patients were compared. Results Psychological anxiety of path group （22.22%） was lower than that of the control group （66.66%）. The 3-year survival rate （69.44%） and the 5-year survival rate （50%） of path group were significantly higher than those in the control group. The odds ratio （8.33%） of path group was also lower than that of the control group （33.33%）， and the above three comparison were statistically significant （P<0.05）. Conclusion The clinical path of the principle of nursing safety management for patients treated in hemodialysis room can effectively relieve the psychological anxiety and fear of patients， and promote the positive communication and cooperation between patients and doctors， so as to improve the health status of the patients. Enhancing the treatment effect， and effectively reducing the incidence of complications have a positive effect. It has the clinical value of a higher promotion.

[Key words] Nursing safety management principle； Clinical pathway； Hemodialysis

腎脏替代治疗包括血液透析、腹膜透析和肾移植，而在目前血液透析是急、慢性肾功能衰竭患者肾脏替代治疗方式之一[1-2]。血液透析简称血透，主要替代肾脏对溶质（主要是小分子溶质）和液体的清除功能，其利用半透膜原理，通过溶质交换清除血液内的代谢废物、维持电解质和酸碱平衡，同时清除过多的液体。血液透析时，血液经过血管通路进入体外循环，在蠕动泵（血泵）的推动下进入透析器（内含透析膜）与透析液发生溶质交换后再经血管通路回到体内。此过程称为血液透析[3-4]。因为血透的治疗成本偏高，治疗周期较长，因此为减轻患者经济、精神负担，减少并发症，提高治疗质量，延长患者治疗后生存率[5-6]，我院制定了护理安全管理的临床路径，对患者进行治疗期间的有效干预，现将临床试用结果报道如下。……