CAJ | 학술논문

目的：探讨规范化管理模式对尿毒症维持血液透析患者水钠控制依从性的影响。方法研究对象为2013年6月至2013年9月在我院行维持血液透析的患者168例，随机分为对照组(84例)和观察组(84例)，对照组采用传统管理模式，患者定期到医院行血液透析，透析治疗时间血透护士对患者进行简单的健康宣教及解答患者提出的问题，专科医师处理患者目前存在的问题，如高血压、贫血等相关问题；观察组采用规范化管理，患者由专职护士进行管理，每名患者建立1份健康档案，督促患者定期复查相关指标，给予个性化饮食指导、尿毒症及血液透析等相关知识宣教，专科医师根据患者情况给予个性化治疗方案，随诊跟踪6个月，比较两组患者透析间期体重增长相对值、液体摄入量、超滤量。结果观察组管理后透析间期体重增长相对值、液体摄入量、超滤量均有明显下降（P＜0.05），水钠控制依从性有明显改善（P＜0.05），而对照组无明显差别。结论规范化管理能提高维持性血液透析患者的水钠控制依从性，减少透析并发症，提高透析质量和患者生活质量。
목적：탐토규범화관리모식대뇨독증유지혈액투석환자수납공제의종성적영향。방법연구대상위2013년6월지2013년9월재아원행유지혈액투석적환자168례，수궤분위대조조(84례)화관찰조(84례)，대조조채용전통관리모식，환자정기도의원행혈액투석，투석치료시간혈투호사대환자진행간단적건강선교급해답환자제출적문제，전과의사처리환자목전존재적문제，여고혈압、빈혈등상관문제；관찰조채용규범화관리，환자유전직호사진행관리，매명환자건립1빈건강당안，독촉환자정기복사상관지표，급여개성화음식지도、뇨독증급혈액투석등상관지식선교，전과의사근거환자정황급여개성화치료방안，수진근종6개월，비교량조환자투석간기체중증장상대치、액체섭입량、초려량。결과관찰조관리후투석간기체중증장상대치、액체섭입량、초려량균유명현하강（P＜0.05），수납공제의종성유명현개선（P＜0.05），이대조조무명현차별。결론규범화관리능제고유지성혈액투석환자적수납공제의종성，감소투석병발증，제고투석질량화환자생활질량。
Objective To investigate effect of standardized management model on water sodium control compliance of uremia maintenance hemodialysis patients.Method study objects of 168 patients of maintenance hemodialysis in our hospital during July, 2013 and September, 2013 were randomLy divided into control group (84 cases) and observation group (84 cases). Control group was treated by traditional management mode, patients received regular hemodialysis in hospital, during which nurses gave simple health education and answer questions of patients, and diplomate treated patients’disease of high blood pressure, anemia and etc. The observation group was applied standardized management, serving patients by full-time nurses, each patient has his health records, and is urged for regularreview of relevant indicators, and is given personalized dietary guidance, uremia andhemodialysis and related knowledge education, diplomate makes personalized treatment plan according to patient’s situation. After following up both groups for 6 months, compare both groups with relative weight gain value, liquid intake, ultrafiltration volume during hemodialysis.Result relative weight gain value, liquid intake, ultrafiltration volume of observation group during hemodialysis after management was significantly decreased (P < 0.05), and compliance of water and sodium was significantly improved (P < 0.05), while control group shows no significant difference.Conclusion standardized management can improve water and sodium compliance of maintenance hemodialysis patients, reduce complications, and improve hemodialysis quality of life quality of patients.