CAJ | 학술논문

目的：探讨行为分阶段转变理论在血液透析患者中的应用。方法选择138例血液透析患者为研究对象，分3个阶段进行干预，比较干预前后患者临床生化指标的变化情况。结果实施干预后，患者血清白蛋白及血红蛋白分别为（39．3±9．1），（108．8±11．7） g/L，明显高于实施前的（37．2±8．3），（105．6±10．4）g/L，干预前后比较差异有统计学意义（t值分别为-2．0029，-2．4014；P＜0．05）。干预前患者收缩压为（148．6±20．5）mm Hg，K＋和Na＋浓度分别为（5．5±1．4），（146．1±16．5）mmol/L，干预后患者收缩压为（141．2±22．3）mmHg，K＋和Na＋浓度分别为（4．9±1．3），（139．2±20．3）mmol/L，均较干预前明显降低，干预前后比较，差异有统计学意义（ t值分别为2．8699，3．6893，3．0985；P＜0．05）。干预后患者体质量、血压和无明显水肿达标率明显提高（P＜0．05）。干预后，SGA评估营养良好的患者较干预前明显增加，分别为40例（44．9％），70例（78．7％），干预前后比较差异有统计学意义（χ2＝16．49，P＜0．05）。结论行为分阶段转变理论有利于控制血液透析患者的血压，改善预后，提高患者生活质量。
목적：탐토행위분계단전변이론재혈액투석환자중적응용。방법선택138례혈액투석환자위연구대상，분3개계단진행간예，비교간예전후환자림상생화지표적변화정황。결과실시간예후，환자혈청백단백급혈홍단백분별위（39．3±9．1），（108．8±11．7） g/L，명현고우실시전적（37．2±8．3），（105．6±10．4）g/L，간예전후비교차이유통계학의의（t치분별위-2．0029，-2．4014；P＜0．05）。간예전환자수축압위（148．6±20．5）mm Hg，K＋화Na＋농도분별위（5．5±1．4），（146．1±16．5）mmol/L，간예후환자수축압위（141．2±22．3）mmHg，K＋화Na＋농도분별위（4．9±1．3），（139．2±20．3）mmol/L，균교간예전명현강저，간예전후비교，차이유통계학의의（ t치분별위2．8699，3．6893，3．0985；P＜0．05）。간예후환자체질량、혈압화무명현수종체표솔명현제고（P＜0．05）。간예후，SGA평고영양량호적환자교간예전명현증가，분별위40례（44．9％），70례（78．7％），간예전후비교차이유통계학의의（χ2＝16．49，P＜0．05）。결론행위분계단전변이론유리우공제혈액투석환자적혈압，개선예후，제고환자생활질량。
Objective To explore the application of the transtheoretical model and stages of change in maintenance hemodialysis patients .Methods One hundred and thirty-eight maintenance hemodialysis patients were chosen and received the three stages of interventions according to the transtheoretical model and stages of change.The changes of clinical biochemical indicator were compared before and after the intervention . Results The levels of the serum albumin and hemoglobin were respectively (39.3 ±9.1) g/L, (108.8 ± 11.7)g/L after the intervention, and were significantly higher than (37.2 ±8.3) g/L, (105.6 ±10.4) g/L before the intervention, and the differences were statistically significant (t=-2.002 9, -2.401 4, respectively;P<0.05).The systolic blood pressure, the concentrations of K +and Na +were respectively (148.6 ±20.5) mmHg, (5.5 ±1.4)mmol/L, (146.1 ±16.5)mmol/L before the intervention, and were significantly higher than (141.2 ±22.3)mmHg, (4.9 ±1.3)mmol/L, (139.2 ±20.3)mmol/L after the intervention, and the differences were statistically significant (t=2.869 9, 3.689 3, 3.098 5, respectively; P<0.05).The body weight, blood pressure and the compliance rate of no obvious edema were significantly increased after the intervention (P<0.05).The cases of well nourished patients evaluated by the SGA were 40 cases (44.9%) before the intervention, and were 70 cases (78.7%) after the intervention, and the difference was statistically significant (χ2 =16.49, P<0.05).Conclusions Transtheoretical model and stages of change is beneficial to control blood pressure , improve the prognosis , and increase the life quality of maintenance hemodialysis patients .