Wan Huijuan, Tang Dongxing
The Second Affiliated Hospital, Department of Nephrology and Rheumatology, Hengyang Medical School, University of South China, Hengyang 421001, Hunan, China.
Evid Based Complement Alternat Med. 2022 Aug 8;2022:9676074. doi: 10.1155/2022/9676074. eCollection 2022.
To explore the application value of nursing intervention under the guidance of risk prevention management concept in preventing vascular access infection in patients undergoing maintenance hemodialysis (MHD).
A total of 100 MHD patients who were admitted to the intensive care unit (ICU) of our hospital from May 2019 to May 2020 were enrolled. Based on the principle of double-blind grouping, patients were randomly divided into the risk management group and control group, with 50 cases in each group. The control group was given routine nursing, while the risk management group was given nursing intervention under the guidance of risk prevention management concept on the basis of the control group. The nursing intervention effect and incidence of vascular access infection were compared between the two groups. The psychological status and quality of life in both the groups were evaluated by the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Short Form 36 Health Survey (SF-36).
After intervention, biochemical indexes (serum albumin, creatinine, and hemoglobin) and body mass in the risk management group were significantly higher than those in the control group, while malnutrition-inflammation score (MIS) was significantly lower than the control group ( < 0.05). After intervention, SAS and SDS scores in both the groups were significantly decreased, which were significantly lower in the risk management group than in the control group ( < 0.05). At 8 w and 12 w after intervention, incidence rates of vascular access infection in risk management group were significantly lower than those in the control group (10.00% vs. 26.00% and 12.00% vs. 34.00%, < 0.05). After intervention, SF-36 scores in each dimension of both the groups were significantly increased, which were significantly higher in the risk management group than in the control group ( < 0.05).
The implementation of nursing intervention under the guidance of risk prevention management concept for MHD patients can effectively improve biochemical indexes, nutritional status, and body mass and reduce the incidence of vascular access infection, which is of great significance for improving psychological status and quality of life.
探讨风险预防管理理念指导下的护理干预在预防维持性血液透析（MHD）患者血管通路感染中的应用价值。
选取2019年5月至2020年5月在我院重症监护病房（ICU）收治的100例MHD患者。按照双盲分组原则，将患者随机分为风险管理组和对照组，每组50例。对照组给予常规护理，风险管理组在对照组基础上给予风险预防管理理念指导下的护理干预。比较两组的护理干预效果及血管通路感染发生率。采用自评焦虑量表（SAS）、自评抑郁量表（SDS）和健康调查简表（SF-36）评估两组患者的心理状态和生活质量。
干预后，风险管理组的生化指标（血清白蛋白、肌酐和血红蛋白）及体重显著高于对照组，而营养不良-炎症评分（MIS）显著低于对照组（P<0.05）。干预后，两组的SAS和SDS评分均显著降低，且风险管理组显著低于对照组（P<0.05）。干预后8周和12周，风险管理组的血管通路感染发生率显著低于对照组（10.00%对26.00%，12.00%对34.00%，P<0.05）。干预后，两组各维度的SF-36评分均显著升高，且风险管理组显著高于对照组（P<0.05）。
对MHD患者实施风险预防管理理念指导下的护理干预，可有效改善生化指标、营养状况和体重，降低血管通路感染发生率，对改善心理状态和生活质量具有重要意义。
