陈爱娥　蒋晓珍　彭健韫　翁晓华

[關键词] 糖尿病肾病;血液透析;优质化护理;血肌酐;尿素氮

[中图分类号] R473.5          [文献标识码] B          [文章编号] 1673-9701（2021）23-0173-04

Analysis on the application value of high-quality service in nursing care of elderly patients with diabetic nephropathy undergoing hemodialysis

CHEN Ai′e   JIANG Xiaozhen   PENG Jianyun   WENG Xiaohua

Department of Blood Purification，Lishui People′s Hospital，Lishui   323000，China

[Abstract] Objective To explore the application value of high-quality services in the nursing of elderly patients with diabetic nephropathy undergoing hemodialysis. Methods From January 2018 to October 2019，120 elderly patients with diabetic nephropathy undergoing hemodialysis in our hospital were enrolled.The patients were randomly divided into two groups of 60 cases each （random number table method）.The control group was given routine nursing care，and the observation group was given high-quality nursing care.The treatment compliance，blood glucose level，renal function indices，negative mood score，quality of life score，and nursing satisfaction were compared between the two groups. Results The total treatment compliance rate was 93.33% in the observation group and 78.33% in the control group.The observation group was higher than the control group （P<0.05）. The fasting blood glucose，2h postprandial blood glucose， blood creatinine， and urea nitrogen after nursing were lower than those before nursing in the both groups （P<0.05）. The fasting blood glucose， 2 h postprandial blood glucose，blood creatinine，and urea nitrogen after nursing in the observation group were all lower than those in the control group （P<0.05）. Anxiety and depression scores were compared between the two groups，and they were lower in the observation group after nursing than those in the control group （P<0.05）. The quality of life score was compared between the two groups，and it was higher in the observation group after nursing than that in the control group （P<0.05）. There was significant difference between the observation group and the control group in the overall satisfaction rate with nursing care （96.67% vs 83.33%， P<0.05）. Conclusion The implementation of high-quality nursing services during hemodialysis in elderly patients with diabetic nephropathy can effectively enhance patients′ compliance with treatment，help improve blood glucose control，and better improve renal function.It can also improve patients' mental conditions，quality of life，and nursing satisfaction.

[Key words] Diabetic nephropathy;Blood hemodialysis;High-quality nursing;Blood creatinine;Urea nitrogen

糖尿病肾病是糖尿病患者最常见的并发症类型之一，由于患者血糖长期处于高水平状态，患者肾功能受到损伤，随着病情进展，患者肾功能损伤加重，是威胁糖尿病患者生命安全的重要原因[1-3]。血液透析是糖尿病肾病临床治疗时常用的一种手段，可对血液中毒素分子进行清除，从而控制患者病情[4]，但由于血液透析治疗周期长，受病情影响，患者易出现焦虑、抑郁等不良情绪，治疗依从性较差，不利于治疗效果，合理的护理措施必不可少。优质化护理是一种近年来临床护理方面大力提倡的理念，其护理目标为“实现优质化医疗服务”，为探讨优质化护理在老年糖尿病肾病血液透析患者护理中的应用价值，本研究对120例老年糖尿病肾病患者进行观察。

1资料与方法

1.1 一般资料

将2018年1月至2019年10月入住我院的120例血液透析老年糖尿病肾病患者采用随机数字表法分为两组，每组各60例。对照组：平均（71.43±9.14）岁，男女分别为33例和27例，平均病程（3.82±0.23）年;观察组：平均（71.68±9.32）岁，男女分别为32例和28例，平均病程（3.82±0.23）年。两组患者年龄、性别无统计学差异（P>0.05），具有可比性。本研究获医学伦理委员会批准和患者知情同意。

1.2 方法

对照组患者给予常规护理，透析时注意监测患者生命体征，并为其耐心讲解相关注意事项。

观察组患者给予优质化护理，具体措施为：（心理护理：收集患者文化水平信息，邀请心理科医师认真聆听患者的倾诉，在聆听过程中了解患者心理动态，分析负性情绪原因，针对原因对患者进行安抚，并及时给患者提供病情信息，消除焦虑、抑郁等负面情绪。（……