血压折线图规律性分析对MHD患者个体化护理干预的效果研究

摘要

目的 根据血压折线图来反映维持性血液透析(MHD)患者透析间期与透析日的血压节律变化的规律性和特点,采取预见性护理干预,观察其对MHD患者疗效的影响.方法 MHD患者200例采用数字表法随机分为试验组和对照组,每组100例.分别将每位MHD患者透析过程中及透析间期不同时间连续测得的血压数据录入,截取血压记录制作折线图,观察血压变化规律.试验组在常规护理的基础上给予个体化护理干预;对照组给予常规护理干预.比较2组血压异常的发生率、生存质量、满意度.结果 2组患者在透析间期与透析日的24 h平均收缩压、24 h平均舒张压、日平均收缩压、日平均舒张压、夜平均收缩压、夜平均舒张压、血压异常发生率、生活质量、满意度比较差异有统计学意义( P <0.05);杓型节律、反杓型节律与非杓型节律发生率比较差异均无统计学意义( P >0.05).结论 MHD患者存在高血压及节律异常,观察记录患者血压异常规律,给予个体化护理预干预可有效降低患者血压异常发生率,改善患者生活质量与满意度.%Objective To analyze the regularity and characteristics of blood pressure rhythm changes during hemodialysis and on hemodialysis day in patients with maintenance hemodialysis (MHD) according to blood pressure broken line graph,to adopt predictive nursing intervention and to observe its effects on therapeutic effects on MHD.Methods Two hundred patients with MHD who were treated in our hospital from February 2016 to February 2017 were randomly divided into experimental group and control group,with 100 patients in each group. The blood pressure data and blood pressure variability of patients were analyzed to observe the regularity of blood pressure changes. Moreover the patients in control group were treated by routine nursing,however,the patients in experimental group,on the basis of control group,were treated by individualized nursing intervention,then the incidence rate of abnormal blood pressure, life quality and satisfaction degree of patients were observed and compared between two groups.Results There were significant differences in 24h average systolic blood pressure,24h mean diastolic blood pressure, daily mean systolic blood pressure, daily mean diastolic blood pressure, night mean systolic blood pressure,night mean diastolic blood pressure,incidence rate of abnormal blood pressures,quality of life and satisfaction degree during dialysis and on dialysis day between two groups ( P <0.05). However there were no significant differences in the incidence rates of dipper type rhythm and contra-dipper type rhythm as well as non-dipper type rhythm between two groups ( P >0.05). Conclusion There exist hypertension and allorhythmia in patients with MHD, to observe the regularity of dysarteriotony and to carry out individualized nursing intervention can effectively decrease the incidence rate of abnormal blood pressure and can improve the life quality and satisfaction degree of patients.