多学科团队协作模式在维持性血液透析患者血管通路管理中的应用研究

Application of multidisciplinary team collaboration model in vascular access management of patients with maintenance hemodialysis

  • 摘要:
    目的 探讨多学科团队协作模式在维持性血液透析患者血管通路管理中的应用效果。
    方法 选取本院2023年10月—2024年10月收治的102例维持性血液透析患者为研究对象, 采用随机数字表法分为观察组和对照组,每组51例。观察组采用常规护理联合多学科团队协作模式,对照组采用常规护理。多学科团队协作模式涉及肾内科医生、血管外科医生、介入放射科医生、B超医生、临床药师、营养师、心理咨询师、血液净化中心护士长及血液净化专科护士等多学科人员,干预时间为6个月。比较2组患者干预前后透析充分性相关指标尿素下降率(URR)、平衡尿素清除率(eKt/V)、心理状况焦虑自评量表(SAS)和抑郁自评量表(SDS)、血管通路满意度简易版血管通路问卷评估(VAQ)、生活质量肾病相关负担量表(KDTA)、简明调查简表(SF-36)、并发症情况。
    结果 实施干预后,观察组URR、eKt/V水平以及生活质量各维度评分均高于对照组, SAS、SDS评分均低于对照组,差异有统计学意义(P < 0.05)。干预后,观察组血管通路满意率为96.08%(49/51), 高于对照组的80.39%(41/51), 差异有统计学意义(χ2=6.044, P=0.014)。观察组并发症总发生率为1.96%(1/51), 低于对照组的13.73%(7/51), 差异有统计学意义(P < 0.05)。
    结论 对维持性血液透析患者采取多学科团队协作模式,有助于改善血液透析的充分性,减轻心理负担,提升血管通路满意度及生活质量,预防并发症。

     

    Abstract:
    Objective To explore the application effect of the multidisciplinary team collaboration model in vascular access management for patients with maintenance hemodialysis.
    Methods A total of 102 patients with maintenance hemodialysis in the hospital from October 2023 to October 2024 were selected as the research subjects, and they were randomly divided into observation group and control group by the random number table method, with 51 cases in each group. The observation group received routine nursing combined with the multidisciplinary team collaboration model, while the control group received routine nursing. The multidisciplinary team collaboration model involved professionals from multiple disciplines, including nephrologists, vascular surgeons, interventional radiologists, B-ultrasound doctors, clinical pharmacists, nutritionists, psychological counselors, the head nurse of the blood purification center, and blood purification specialist nurses. The intervention duration was 6 months. The related indicators of dialysis adequacy urea reduction ratio (URR), equilibrium urea clearance rate (eKt/V), psychological burden the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), vascular access satisfaction degree the Simple Version of Vascular Access Questionnaire (VAQ), quality of life the Kidney Disease-Targeted Areas Scale (KDTA) and the 36-item Short-form Health Survey (SF-36), and complications were compared between the two groups before and after the intervention.
    Results After the intervention, the levels of URR and eKt/V and the score of each dimension of quality of life in the observation group were significantly higher than those in the control group, while the SAS and SDS scores were significantly lower than those in the control group (P < 0.05). After the intervention, the satisfaction rate of vascular access in the observation group was 96.08% (49/51), which was significantly higher than 80.39% (41/51) in the control group (χ2=6.044, P=0.014). The total complication rate in the observation group was 1.96% (1/51), which was significantly lower than 13.73% (7/51) in the control group (P < 0.05).
    Conclusion The adoption of the multidisciplinary team collaboration model for patients with maintenance hemodialysis is beneficial for improving the adequacy of hemodialysis, reducing psychological burden, enhancing vascular access satisfaction and quality of life, and preventing complications.

     

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