中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (03): 201-204.doi: 10.3969/j.issn.1671-4091.2020.03.015

• 护理研究 • 上一篇    下一篇

契约式管理对腹膜透析患者的容量管理效果

刘丽1,吴燕妮1,张蕊1   

  1. 1哈尔滨医科大学附属第二医院肾内三病房
  • 收稿日期:2019-10-21 修回日期:2020-01-06 出版日期:2020-03-12 发布日期:2020-03-12
  • 通讯作者: 刘丽 liulihyd@126.com E-mail:1399112807@qq.com
  • 基金资助:
    renal research grant(百特)，NCT02782234

Contractual management model improved fluid status in peritoneal dialysis patients

  1. 1 Department of Nephrology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
  • Received:2019-10-21 Revised:2020-01-06 Online:2020-03-12 Published:2020-03-12

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摘要： 【摘要】目的用契约式管理方式对容量超负荷的腹膜透析患者进行容量管理，并进行效果分析。方法选取哈尔滨医科大学附属第二医院腹膜透析中心经人体成分分析仪筛选容量超负荷并满足入组标准患者随机分为实验组与对照组，对照组实施常规健康教育，实验组在此基础上实施契约式管理并签订健康管理协议。观察时间为6 个月，比较2 组容量管理行为、容量状况和透析相关指标以及实验室检查结果等的差异。结果观察6 个月后，相对于对照组，实验组患者体质量降低(t=-3.201，P=0.002)；对血压的监测次数增加(Z= -2.265，P=0.024)，液体摄入量减少(Z=-2.285，P=0.022)；实验组容量超负荷指标改善(t=-3.623，P=0.001)。结论契约式管理对腹膜透析患者的容量管理有明显约束作用，能改善其容量管理行为，改善患者容量状况。

关键词: 腹膜透析, 契约式管理, 容量管理, 容量状况, 健康管理模式

Abstract:

【Abstract】Objective To evaluate the effectiveness of contractual management on fluid status in peritoneal dialysis (PD) patients. Methods Patients with over hydration screened by human body composition monitor and met the inclusion criteria from the Peritoneal Dialysis Center of the Second Affiliated Hospital of Harbin Medical University were randomly assigned into two groups. Patients in control group received routine health care and those in experimental group adopted contract management on the basis of routine health education and signed a health care agreement. The volume management behavior, volume status, dialysis related indicators and laboratory examination results were compared before intervention and after intervention for 6 months. Results In experiment group after the intervention for 6 months, body weight decreased as compared with that in control group (t=-3.201, P=0.002), the times of blood pressure measurement per week increased (Z=-2.265, P=0.024), liquid intake decreased (Z=-2.285, P=0.022), and over hydration parameters improved (t=-3.623, P=0.001). Conclusion Contractual management is a management mode that obviously restricts the volume management of PD patients. This management can improve the volume management behavior and volume status in PD patients.

Key words: Peritoneal dialysis, Contractual management, Volume management, Volume status, Health management model

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