基于互联网平台的闭环式健康管理对腹膜透析患者效果的观察：一项随机试验。

Observation of the effect of closed-loop health management based on an internet platform in patients with peritoneal dialysis: a randomized trial.

机构信息

Department of Renal Medicine, Xuzhou Central Hospital, Xuzhou, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7832-7840. doi: 10.21037/apm-21-1402.

DOI:10.21037/apm-21-1402

PMID:34353070

Abstract

BACKGROUND

Peritoneal dialysis (PD) uses the peritoneum as the dialysis membrane. PD is a simple operation for self-treatment at home, and has become the preferred option for most patients with chronic renal failure (CRF). This study aimed to explore the effect of a closed-loop health management (CLHM) system based on an Internet platform in patients with PD.

METHODS

A total of 102 patients with PD who were admitted to Xuzhou Central Hospital from May 2019 to May 2020 were selected and randomly divided into two groups (n=51). The control group received routine care, and in the observation group a CLHM based on an Internet platform was introduced. The incidence of complications and changes in disease knowledge, nutritional status, quality of life (QOL) before and after the intervention were compared between groups.

RESULTS

The incidences of peritonitis, tunnel entrance infection, poor drainage, and hypokalemia in the observation group were lower than in the control group (P<0.05). The disease-related knowledge mastery scores of the observation group were higher than those in the control group after 3 months of intervention (P<0.05). Malnutrition-inflammation score (MIS) and serum creatinine (SCr) in the observation group were lower than in the control group after 3 months of intervention (P<0.05), and the body mass index (BMI), albumin (ALB), and hemoglobin (Hb) of the observation group were higher than those of the control group (P<0.05). The QOL scores of the observation group were higher than those of the control group after 3 months of intervention (P<0.05).

CONCLUSIONS

The application of a CLHM system based on an Internet platform to patients with PD could effectively reduce complications, and improve patients' knowledge of disease, nutritional status and QOL.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: ChiCTR2100046122.

摘要

背景

腹膜透析（peritoneal dialysis，PD）利用腹膜作为透析膜。PD 是一种简单的家庭自我治疗操作，已成为大多数慢性肾衰竭（chronic renal failure，CRF）患者的首选治疗方法。本研究旨在探讨基于互联网平台的闭环健康管理（closed-loop health management，CLHM）系统对 PD 患者的影响。

方法

选取 2019 年 5 月至 2020 年 5 月徐州中心医院收治的 102 例 PD 患者，随机分为两组（n=51）。对照组给予常规护理，观察组引入基于互联网平台的 CLHM。比较两组患者干预前后并发症发生率及疾病知识、营养状况、生活质量（quality of life，QOL）变化。

结果

观察组腹膜炎、隧道入口感染、引流不畅、低钾血症的发生率低于对照组（P<0.05）。观察组干预 3 个月后疾病相关知识掌握评分高于对照组（P<0.05）。观察组干预 3 个月后营养不良-炎症评分（malnutrition-inflammation score，MIS）和血清肌酐（serum creatinine，SCr）低于对照组（P<0.05），观察组体质量指数（body mass index，BMI）、白蛋白（albumin，ALB）和血红蛋白（hemoglobin，Hb）高于对照组（P<0.05）。观察组干预 3 个月后 QOL 评分高于对照组（P<0.05）。