發(fā)布時(shí)間：2018-01-01 06:28

  本文關(guān)鍵詞：容量管理對(duì)持續(xù)非臥床腹膜透析患者容量負(fù)荷及心功能的影響　出處：《蘇州大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 持續(xù)非臥床腹膜透析 容量管理 容量負(fù)荷 心功能

【摘要】：目的本研究旨在探討容量管理對(duì)持續(xù)非臥床腹膜透析（ContinuousAmbul-atory Peritoneal Dialysis, CAPD）患者容量負(fù)荷及心功能的影響。 方法篩選符合納入標(biāo)準(zhǔn)的CAPD患者，隨機(jī)分入干預(yù)組（N=34例）和對(duì)照組（N=32例）。干預(yù)組患者予以容量管理6個(gè)月，包括：（1）出院時(shí)發(fā)放與講解《CAPD患者容量管理手冊(cè)》，內(nèi)容主要圍繞容量管理的必要性、提高容量管理綜合能力、異常容量負(fù)荷指標(biāo)的監(jiān)測(cè)、識(shí)別和處理等；（2）按容量管理計(jì)劃給予門診和（或）電話跟蹤隨訪。對(duì)照組予以常規(guī)護(hù)理。比較兩組患者《容量相關(guān)知識(shí)調(diào)查表》、《慢性病自我效能量表》和《CAPD患者容量管理行為量表》得分；比較兩組CAPD患者整體水平（水腫、體重、出量及血壓）和細(xì)胞與組織水平（ICW、ECW、TBW及ECW"h）的容量負(fù)荷、心功能（BNP水平）及6個(gè)月內(nèi)因容量超負(fù)荷相關(guān)疾病的再入院次數(shù)。 結(jié)果 1.6個(gè)月后，干預(yù)組患者容量管理知識(shí)、自我效能及限鹽限水行為得分均顯著高于對(duì)照組，比較有統(tǒng)計(jì)學(xué)意義（p均＜0.05）。與基線比較，，干預(yù)組容量管理知識(shí)、信念、行為得分顯著高于基線時(shí)，差異有統(tǒng)計(jì)學(xué)意義（p均＜0.05）；而對(duì)照組的差異無(wú)統(tǒng)計(jì)學(xué)意義（p均＞0.05）。 2.容量負(fù)荷 2.1整體水平：6個(gè)月后，干預(yù)組水腫程度顯著改善、體重顯著下降、收縮壓降至140.82±20.89mmHg，組間差異均有統(tǒng)計(jì)學(xué)意義（p均＜0.05）。與基線相比，干預(yù)組上述三項(xiàng)指標(biāo)均顯著下降，差異有統(tǒng)計(jì)學(xué)意義（p均＜0.05），而對(duì)照組上述指標(biāo)的改變均無(wú)統(tǒng)計(jì)學(xué)意義。 2.2細(xì)胞與組織水平：6個(gè)月后，干預(yù)組的ICW、ECW、TBW及ECW"h低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（p均＜0.05）。與基線比較，干預(yù)組的上述指標(biāo)均有下降，但無(wú)統(tǒng)計(jì)學(xué)意義；而對(duì)照組上述指標(biāo)均呈上升趨勢(shì)。 3.6個(gè)月后，干預(yù)組BNP水平較對(duì)照組有所改善，差異有統(tǒng)計(jì)學(xué)意義（χ2=5.945，p=0.019）。 4.因容量超負(fù)荷相關(guān)疾病的再入院次數(shù)：干預(yù)組平均住院（0.177±0.459）次，對(duì)照組（0.469±0.671）次，兩組差異有統(tǒng)計(jì)學(xué)意義（t=2.053， p=0.045）。 結(jié)論容量管理可從知-信-行方面有效提高CAPD患者的容量管理能力，從而改善容量超負(fù)荷癥狀及心功能水平，降低容量超負(fù)荷相關(guān)疾病導(dǎo)致的再入院次數(shù)，故容量管理是一種簡(jiǎn)便、經(jīng)濟(jì)、有效的改善CAPD患者容量超負(fù)荷及心功能不全的方法。
[Abstract]:Objective to investigate the effect of volume management on continuous ambulatory Peritoneal Dialysis in continuous ambulatory peritoneal dialysis. The effect of volume load and cardiac function in patients with CAPD. Methods 34 patients with CAPD were randomly divided into the intervention group (n = 34) and the control group (n = 32). The patients in the intervention group were given volume management for 6 months. Including 1) release and explain the Handbook of capacity Management of CAPD patients when discharged from hospital. The contents mainly focus on the necessity of capacity management, improve the comprehensive capacity management ability, and monitor the abnormal capacity load index. Identification and processing; (2) according to the capacity management plan, the outpatients and / or telephone follow-up were given. The patients in the control group were given routine nursing care. The volume related knowledge questionnaire was compared between the two groups. Scores of chronic self-efficacy scale and CAPD patient capacity management behavior scale; The volume load of CAPD patients (edema, body weight, output and blood pressure), cell and tissue levels and ECW "TBW" were compared between the two groups. Cardiac function (BNP level) and readmission times due to volume overload related diseases within 6 months. Results After 6 months, the scores of capacity management knowledge, self-efficacy and salt and water limitation behavior in the intervention group were significantly higher than those in the control group (P < 0.05). The scores of capacity management knowledge, belief and behavior in the intervention group were significantly higher than those in the baseline group (P < 0.05). There was no significant difference in the control group (P > 0.05). 2. Capacity load 2.1 overall level: after 6 months, the degree of edema and body weight in the intervention group were significantly improved, and the systolic blood pressure decreased to 140.82 鹵20.89 mmHg. Compared with the baseline, the above three indexes in the intervention group were significantly decreased, and the difference was statistically significant (P < 0.05). The changes of the above indexes in the control group were not statistically significant. 2.2 Cell and tissue levels: after 6 months, the levels of ECW "TBW and ECW in the intervention group were significantly lower than those in the control group (P < 0.05). The above indexes in the intervention group were all decreased, but there was no statistical significance. In the control group, the above indexes showed an upward trend. After 6 months, the level of BNP in the intervention group was better than that in the control group, and the difference was statistically significant (蠂 ~ 2 = 5.945). 4. The number of readmissions due to volume overload related diseases: the average number of hospitalizations was 0.177 鹵0.459 in the intervention group and 0.469 鹵0.671 in the control group. The difference between the two groups was statistically significant. Conclusion Volume management can effectively improve the capacity management ability of patients with CAPD from the aspect of knowledge, trust and behavior, thereby improving the symptoms of volume overload and the level of cardiac function. Volume management is a simple, economical and effective method to improve volume overload and cardiac insufficiency in patients with CAPD because of reducing the number of readmission due to volume overload related diseases.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R473.5

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