中国血液净化 ›› 2025, Vol. 24 ›› Issue (11): 889-894.doi: 10.3969/j.issn.1671-4091.2025.11.003

• 健康体重·医者先行 • 上一篇    下一篇

维持性血液透析患者干体质量管理的最佳证据总结

肖佳仪    孙贝蒂    高 康    刘映宏   

  1. 646000 泸州,1西南医科大学护理学院
    646000 泸州,2西南医科大学附属医院肾病内科
  • 收稿日期:2025-04-27 修回日期:2025-08-16 出版日期:2025-11-12 发布日期:2025-11-12
  • 通讯作者: 刘映宏 E-mail:605092505@qq.com
  • 基金资助:
    西南医科大学校级课题(JG2023yb176)

Summary of the best evidence for dry weight management in maintenance hemodialysis patients

XIAO Jia-yi, SUN Bei-di, GAO Kang, LIU Ying-hong   

  1. School of Nursing, Southwest Medical University, Luzhou 646000,China; 2Department of Nephrology, Affiliated Hospital of Southwest Medical University, Luzhou 646000,China
  • Received:2025-04-27 Revised:2025-08-16 Online:2025-11-12 Published:2025-11-12
  • Contact: 646000 泸州,1西南医科大学护理学院 E-mail:605092505@qq.com

摘要: 目的  对维持性血液透析患者干体质量管理的相关证据进行检索、提取、评价和整合,为医护人员制定维持性血液透析患者干体质量管理方案提供循证依据。 方法  按照“6S”证据金字塔模型检索国内外网站、指南库、数据库中关于维持性血液透析患者干体质量管理的相关证据,包括指南、专家共识、证据总结、临床决策、系统评价、Meta分析及原始研究。检索时限为2020年1月1日—2025年1月1日。 结果  共纳入16篇文献,包括指南5篇,系统评价4篇,证据总结1篇,随机对照试验5篇,队列研究1篇。总结出干体质量评估及优化、限钠与行为干预、干体质量科学管理、透析频率及时间、透析液个性化调整、透析温度与时长6个维度,共27条证据。 结论  本研究为维持性血液透析患者干体质量管理提供了最佳证据,为医护人员临床实践提供了循证依据。

关键词: 维持性血液透析, 干体质量管理, 循证护理

Abstract: Objective  To retrieve, extract, evaluate, and integrate evidence on dry weight management in maintenance hemodialysis (MHD) patients to provide an evidence-based basis for healthcare professionals to develop a dry weight management program for MHD patients.  Methods  To search for evidence related to the management of dry body quality in MHD patients in domestic and international websites, guideline repositories, and databases according to the “6S” evidence pyramid model, including guidelines, expert consensus, evidence summaries, clinical decision-making, systematic evaluations, meta-analyses, and original studies. The timeframe for the search was January 1, 2020 to January 1, 2025.  Results  A total of 16 articles were ultimately included in the literature, comprising 5 guidelines, 4 systematic evaluations, 1 evidence summary, 5 randomized controlled trials, and 1 cohort study. A total of 27 pieces of evidence were summarized in 6 dimensions: dry weight assessment and optimization, sodium restriction and behavioral interventions, scientific management of dry weight, frequency and duration of dialysis, personalized adjustment of dialysis solution, and dialysis temperature and duration.   Conclusion  This study provides the best evidence for the management of dry body quality in MHD patients and serves as a reference for evidence-based clinical practice by healthcare professionals.

Key words: Maintenance hemodialysis, Dry weight management, Evidence-based nursing

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