江冬梅

[摘要] 目的 探讨临床护理路径在腹膜透析相关性腹膜炎中的应用效果。 方法 采用回顾性方法，选取2016年2月～2017年2月以来我院收治的56例慢性肾衰竭患者的临床资料，按照护理方法的不同随机分为对照组和观察组，各28例，對照组给予常规腹膜透析后的相关抗炎和饮食指导常规护理，观察组在对照组护理的基础上，给予临床护理路径法进行护理，观察两组患者的相关护理疗效及其相关性腹膜炎的发生率。 结果 观察组患者临床护理应用总有效率为89.29%（25/28）明显高于对照组的67.86%（19/28），差异有统计学意义（P<0.05）；观察组治疗前肾功能指标情况上血肌酐（Cr）、尿素氮（BUN）、血清尿素（SU）、血尿酸和尿尿酸（UA）等肾功能情况与对照组比较，差异无统计学意义（P>0.05），治疗后组间比较差异具有统计学意义（P<0.05）。 结论 临床护理路径在腹膜透析相关性腹膜炎中的应用效果确切，具有较高的安全性，且能够延长患者的生存时间，值得临床推广应用。

[关键词] 临床护理路径；腹膜透析；相关性腹膜炎；应用效果

[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2017）35-0152-03

[Abstract] Objective To explore the application effect of clinical nursing pathway in peritoneal dialysis-related peritonitis. Methods The clinical data of 56 patients with chronic renal failure who were admitted to our hospital from February 2016 to February 2017 were selected and were retrospectively analyzed. In accordance with the different nursing methods， the patients were randomly divided into control group（n=28） and observation group（n=28）. The control group was given related anti-inflammatory and diet-guided routine care after conventional peritoneal dialysis. The observation group was given the clinical nursing path method for nursing on the basis of the nursing in the control group. The related nursing efficacy and the incidence rate of related peritonitis in the two groups were observed. Results The total effective rate of clinical nursing in the observation group was 89.29%（25/28）， which was significantly higher than that of 67.86% in the control group（19/28）， and the difference was statistically significant（P<0.05）； there was no statistically significant difference between the observation group and the control group before treatment in terms of renal function indices such as serum creatinine （Cr）， blood urea nitrogen （BUN）， serum urea （SU）， serum uric acid and urine uric acid （UA）. After treatment， the differences were statistically significant （P<0.05）. Conclusion The application effect of clinical nursing pathway in peritoneal dialysis-related peritonitis has a definite effect， with a higher safety， and it can prolong the survival time of patients， which is worthy of clinical promotion and application.

[Key words] Clinical nursing pathway； Peritoneal dialysis； Related peritonitis； Application effect

腹膜透析是肾脏替代和支持治疗对急慢性肾衰竭患者的临床治疗方法，与血液透析疗法相比，更能通过透析膜对水和溶质进行交换，达到对患者血液净化治疗的目的。腹膜透析相关性腹膜炎是透析治疗中常见和多发病症，也是临床实践中重点加强的问题。从危害程度来讲，腹膜透析相关性腹膜炎的发生率，是腹膜透析疗法中常见的并发症，会导致患者住院率增加、腹膜功能丧失、残余肾功能下降、放弃 PD 治疗，对透析质量和患者生命健康带来严重的威胁[1]。临床研究证实临床护理路径对患者的治疗能起到很好的效果。为探讨临床护理路径腹膜透析相关性腹膜炎的临床应用效果，特选取我院56例慢性肾衰竭患者作为本研究对象，现报道如下。……