实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (11): 1174-1177.doi: 10.3969/j.issn.1003-9198.2025.11.020

• 护理园地 • 上一篇    下一篇

分阶段匹配护理干预模式改善老年血液透析病人内瘘并发症的观察分析

朱琴, 李昕, 胡敏   

  1. 200011 上海市,上海交通大学医学院附属第九人民医院护理部(朱琴,胡敏);肾科(李昕)
  • 收稿日期:2025-03-05 发布日期:2025-11-26
  • 通讯作者: 胡敏,Email:13651793424@163.com

Study on stage-matched nursing intervention model in improving the complications of internal fistula in elderly patients receiving hemodialysis

ZHU Qin, LI Xin, HU Min   

  1. Nursing Department(ZHU Qin, HU Min);Department of Nephrology (LI Xin), Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Received:2025-03-05 Published:2025-11-26
  • Contact: HU Min, Email: 13651793424@163.com

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摘要： 目的 分析分阶段匹配护理干预模式在老年血液透析病人内瘘护理中的应用效果。方法 将上海交通大学医学院附属第九人民医院收治的212例血液透析病人随机分为对照组和观察组,每组106例。其中对照组予以常规内瘘护理,观察组采取分阶段匹配护理干预模式,所有入组病人观察6个月,比较2组自我护理行为依从率及内瘘并发症的发生率。结果 干预6个月后,观察组病人内瘘自我护理行为处于前意向阶段、意向阶段、准备阶段的比例显著低于对照组,而处于行动阶段和维持阶段的比例则显著高于对照组,差异有统计学意义(P>0.05);观察组自护能力评分亦显著高于对照组(P>0.05),内瘘并发症总发生率显著低于对照组(13.21% 比 35.85%,P>0.05)。结论 对血液透析病人予以分阶段匹配护理干预模式能够提升内瘘护理质量,改善病人行为,减少动静脉内瘘并发症的发生。

关键词: 血液透析, 内瘘护理, 分阶段匹配护理, 并发症

Abstract: Objective To evaluate the effect of stage-matched nursing intervention (SMNI) in the care of arteriovenous fistula (AVF) in the elderly patients receiving maintenance hemodialysis (MHD). Methods A total of 212 patients undergoing MHD in Shanghai Ninth People’s Hospital were enrolled and randomly divided into control group (n=106) and observation group (n=106). The control group was treated with routine AVF nursing, while the observation group was treated with SMNI. Each patient was observed for 6 months, and the behavioral compliance rate and the incidence of AVF complications were recorded and compared. Results After 6 months of intervention, the proportion of patients in the pre-intentional stage, intentional stage, and preparatory stage of AVF self-care behaviors was significantly lower and the proportion of them in the action phase and maintenance phase was significantly higher in the observation group than that in the control group (P<0.05). The self-care ability score of the observation group was significantly higher and the total incidence rate of AVF complications was significantly lower (13.21% vs 35.85%) in the observation group than that in the control group (P<0.05). Conclusions Application of SMNI in MHD patients can significantly improve the quality of AVF nursing, modify the behavior of the MHD patients and reduce the incidence of AVF complications.

Key words: hemodialysis, arteriovenous fistula care, stage-matched nursing, complications

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