“一护一患”护理模式对维持性血液透析患者钙磷代谢的影响

摘要

目的 探讨“一护一患”护理模式对维持性血液透析(MHD)患者钙磷代谢的影响.方法 随机抽取在本院正规血液透析3个月以上稳定的MHD患者100例为研究对象,研究之初断面统计患者的血钙、血磷、血甲状旁腺激素(PTH)水平、钙磷乘积.随后对这100例患者以“一护一患”的护理管理模式进行管理,随访并指导半年,护理干预结束时再次统计患者的血钙、血磷、血PTH水平、钙磷乘积情况,并进行前后自身对照统计分析.结果 经过“一护一患”护理管理后血液透析患者的血磷水平显著低于护理干预前[(1.80±0.28) mmol/Lvs (2.09±0.44) mmol/L]、钙磷乘积水平显著低于护理干预前[(3.88±0.85) mmol2/L2 vs (4.63±1.20)mmol2/L2、血PTH水平显著低于护理干预前[(238.36±33.86) pg/ml vs (314.69±43.26) pg/ml],差异均有统计学意义(P＜0.05)；血钙水平与护理干预前差异无统计学意义[(2.17±0.23) mmol/L vs (2.20±0.24) mmol/L,P＞0.05)].结论 “一护一患”护理管理模式可以显著改善维持性血液透析患者的钙磷代谢,纠正血液透析患者的高磷、高PTH血症及高钙磷乘积状态.%Objective To explore the effect of "one nurse one patient" nursing model on calcium and phosphate metabolism in maintenance hemodialysis (MHD) patients. Methods One hundred MHD patients treated for over three months in our hospital were enrolled in the study. The serum calcium, serum phosphorus, serum PTH and calcium-phosphorus products were tested before and after the management of the "one nurse one patient" nursing model. Results The level of serum phosphorus, calcium-phosphorus products and serum PTH were significantly lower after the management than those before the management, (1.80?.28) mmol/L vs (2.09?.44) and (3.88?.85) mmol2/L2vs (4.63?.20) mmolVL2, respectively (P<0.05). But no statistically significant differences was found in the level of albumin, (2.17?.23) mmol/L vs (2.20?.24) mmol/L, P>0.05. Conclusion The "one nurse one patient" nursing model can improve the level of serum phosphorus and calcium-phosphorus products in MHD patients.