刘少邦　田大为　卢丽

[摘要] 目的 探讨综合护理干预在维持性血液透析合并动静脉内瘘患者中的护理效果。 方法 选择2015年3月～2017年5月湖北医药学院附属东风医院收治的维持性血液透析合并动静脉内瘘患者110例作为研究对象，采用随机数字表法分为对照组和观察组，每组各55例。对照组采用常规护理干预，观察组采用综合护理干预，采用SF-36生活质量量表对两组患者干预前后躯体、认知、社会、情绪及角色功能进行评估，比较两组总并发症发生率。 结果 干预前两组躯体、认知、社会、情绪及角色功能评分比较，差异无统计学意义（P > 0.05）；干预后两组上述评分均高于干预前，观察组明显高于对照组，差异均有统计学意义（P < 0.05）。观察组总并发症发生率明显低于对照组，差异有统计学意义（P < 0.05）。 结论 综合护理干预在维持性血液透析合并动静脉内瘘患者中的护理效果较好，有助于改善患者的生活质量及预后，值得临床推广应用。

[关键词] 综合护理干预；维持性血液透析；动静脉内瘘；护理效果；预后

[中圖分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0145-04

[Abstract] Objective To investigate the nursing effects of comprehensive nursing intervention on maintenance hemodialysis patients combined with arteriovenous fistula and its prognosis. Methods From March 2015 to May 2017， 110 patients of maintenance hemodialysis combined with arteriovenous fistula admitted to Dongfeng Hospital Affiliated to Hubei University of Medicine were selected as the research objects and divided into the control group and the observation group by random number table， with 55 cases in each group. The control group was given conventional nursing intervention， while the observation group was given comprehensive nursing intervention. The 36-item short form health survey was used to evaluate the physical， cognitive， social， emotional and role functions between the two groups before and after intervention. The total incidence of complications between the two groups was compared. Results Before intervention， there were no statistically significant differences in the scores of physical， cognitive， social， emotional， and role functions in the two groups （P > 0.05）； after intervention， the scores above in the two groups were significantly higher than those of before intervention and the scores above in the observation group were significantly higher than those of control group， with statistically significant differences （P < 0.05）. The total incidence of complications in the observation group was significantly lower than that of control group， with statistically significant differences （P < 0.05）. Conclusion The effect of comprehensive nursing intervention in patients of maintenance hemodialysis combined with arteriovenous fistula is better， which is helpful to improve life quality and prognosis of patients. It is worthy of promotion and application.

[Key words] Comprehensive nursing intervention； Maintenance hemodialysis； Arteriovenous fistula； Nursing effect； Prognosis

维持性血液透析是临床上终末期肾衰竭患者中常用的治疗方法，能延长患者寿命，提高患者生活质量[1]。自体动静脉内瘘是血液透析患者中经典的、永久性的血管通路，被视为血液透析患者的“生命线”[2]。但是长期维持性血液透析需要对自体动静脉瘘进行反复穿刺，容易造成动静脉瘘发生硬化、狭窄，严重者甚至会引起血栓等[3-4]。有研究表明[5]，将综合护理干预用于维持性血液透析合并动静脉内瘘患者中效果理想，有助于改善患者预后，但是该结论有待验证。本研究拟探讨综合护理干预在维持性血液透析合并动静脉内瘘患者中的护理效果及对预后的影响。现……