朱敏敏

[摘要] 目的 对保护性护理干预在血液透析患者预防内瘘闭塞中的临床应用进行探究。方法 方便选取2017年10月—2018年10月期间在该院使用內瘘进行维持性血液透析患者76例作为研究对象，随机分为对照组（常规组基础护理）及治疗组（保护性护理），每组38例，比较两组护理效果。 结果 治疗组内瘘闭塞总发生率为1例（2.63）%与对照组，比较差异（χ2=8.968，P<0.05）;治疗组遵医嘱用药评分为（35.17±2.17）分、避免压迫（71.2±2.54）分、预防感染（34.60±2.11）分、自我监测（79.1±1.51）分、内瘘异常处理（28.70±1.92）分，明显高于对照组，组间差异有统计学意义（P<0.05）;治疗组护理总满意度为37例（97.36%），明显高于对照组（χ2=8.657，P<0.05）。 结论 实施保护性护理干预可对血液透析患者预防内瘘闭塞的应用效果显著，值得临床推广。

[关键词] 保护性护理;血液透析;预防;内瘘闭塞;应用

[中图分类号] R473          [文献标识码] A          [文章编号] 1674-0742（2019）05（a）-0154-03

[Abstract] Objective To explore the clinical application of protective nursing intervention in prevention of internal fistula occlusion in hemodialysis patients. Methods A total of 76 patients with maintenance hemodialysis who underwent internal hemorrhoids in our hospital from October 2017 to October 2018 were convenient selected and randomly divided into the control group （conventional group basic nursing） and the treatment group （protective nursing）， 38 patients in each group. The nursing effect of the two groups were compared. Results The total incidence of sputum occlusion in the treatment group was 1 cases（2.63）%. Compared with the control group， the difference was obvious （χ2=8.968， P<0.05）. In the treatment group， the score of following doctors prescription was （35.17±2.17）points， the score of avoiding oppression was （71.2±2.54）points， the score of preventing infection was （34.60±2.11）points， the score of self-monitoring was （79.1±1.51）points， and the score of internal fistula abnormal treatment was （28.70±1.92）points， which were significantly higher than those in the control group， the difference between the groups was significant （P<0.05） The total satisfaction of the treatment group was 37 cases（97.36）%， which was significantly higher than that of the control group （χ2=8.657， P<0.05）. Conclusion The effect of protective nursing intervention on prevention of internal fistula occlusion in hemodialysis patients is significant and worthy of clinical popularization.

[Key words] Protective nursing; Hemodialysis; Prevention; Internal fistula occlusion; Application

血液透析在肾病科是急慢性肾功能衰竭患者肾脏替代治疗的主要治疗手段，可通过体内血液引出体外，并借助一种净化装置，将致病物质进行清除，净化血液进而达到治疗的目的。而动静脉内瘘亦是血液透析中最为理想的血管通路，是透析患者依靠生存的关键。由于部分患者存在血管条件较差或多次穿刺血管损伤等因素，使得透析治疗过程中动静脉内瘘出现异常，影响透析效果，同时还增加了患者及家属的经济负担[1]。因此，为有效保持患者血管通路的功能状态以及生活质量，该研究方便选取2017年10月—2018年10月期间在该院收治的76例长期血液透析患者作为研究对象，现报道如下。

1  资料与方法

1.1  一般资料

方便选取在该院接受维持性血液透析的76例患者的临床资料进行回顾分析，以上纳入研究的对象和家属均知晓并同意参与，并签署知情同意书。按就诊的前后顺序分成对照组38例（传统护理模式）和治疗组38例（保护性护……