家庭签约模式下的延续护理在尿毒症血液透析患者不宁腿综合征中的应用效果(1)
[摘要]目的 探讨家庭签约模式下的延续护理在尿毒症血液透析患者不宁腿综合征(RLS)中的应用效果，旨在为更好开展家庭签约、规范延续护理、开辟改善RLS的护理新途径提供依据。方法 选取2016年1月～2017年12月于南昌大学第四附属医院肾内科就诊的60例血液透析RLS患者作为研究对象，采用随机数字表法将其分为试验组和对照组，每组各30例。对照组患者采用尿毒症血液透析常规护理，试验组患者在尿毒症血液透析常规护理基础上，给予家庭签约模式下的延续护理。比较两组患者护理6个月后的护理效果，比较两组患者护理前后的睡眠质量。结果 试验组患者的护理总有效率为93.33%，明显高于对照组63.33%，且试验组患者的睡眠质量评分低于对照组，差异有统计学意义(P<0.05)。结论 在尿毒症血液透析常规护理的基础上，开展家庭签约模式下的延续护理，对尿毒症血透患者RLS患者的症状、体征改善及睡眠质量提高均有良好效果，使患者的生活质量得到了较大提高。
[关键词]尿毒症;血液透析;不宁腿综合征;护理
[中图分类号] R658.3 [文献标识码] A [文章编号] 1674-4721(2019)10(c)-0177-04
[Abstract] Objective To explore the application effect of continuous nursing care under family contract mode on uremic hemodialysis patients with restless leg syndrome (RLS)， in order to provide basis for better carrying out family contract， standardizing continuous nursing and opening up new ways of improving RLS nursing. Methods A total of 60 hemodialysis patients with RLS admitted to the department of nephrology of the Fourth Affiliated Hospital of Nanchang University from January 2016 to December 2017 were selected as the study subjects. They were divided into experimental group and control group by random number table method， with 30 patients in each group. Patients in the control group were treated with routine care of uremia hemodialysis， and patients in the experimental group were given continuous nursing care under family contract mode on the basis of routine care of uremia hemodialysis. The nursing effect after 6 months of nursing and sleep quality before and after nursing were compared between the two groups. Results The total effective rate of nursing in the experimental group was 93.33%， which was significantly higher than that of the control group (63.33%)， the sleep quality scale score in the experimental group was lower than that in the control group， the differences were statistically significant (P<0.05). Conclusion On the basis of the routine nursing of uremia hemodialysis， the continuous nursing under the family contract mode has a good effect on the improvement of clinical symptoms， signs and sleeping quality of uremic hemodialysis patients with RLS and thus has greatly improved their living quality.
[Key words] Uremia; Hemodialysis; Restless leg syndrome; Nursing
不寧腿综合征(restless leg syndrome，RLS)是尿毒症维持性血液透析患者一种严重的神经系统并发症，发病率为20%～40%，主要表现为睡眠期间发生非痛性、非痉挛性腿部不适，已严重影响了患者的睡眠及生活质量[1-2]。现有的针对尿毒症血液透析RLS患者的治疗措施只有血液净化及使用药物内科保守治疗(神经营养、改善血管微循环、促进毒素从体内排除等)，至今缺乏特异性病因疗法[3-4]，如何改善RLS已成为医护研究的重点。家庭医生签约服务是指居民自由选择社区医生并自愿签订服务协议，享受社区卫生服务团队为其提供的医疗健康管理服务[5]。转变医疗卫生服务模式，实行家庭医生签约服务，是深化医药卫生体制改革的重要任务，也是新形势下更好维护人民群众健康的重要途径[6]。研究表明，通过个性化的整体护理可使患者在生理、心理、社会等等方面达到最愉快的状态，减轻患者不适感，促进患者康复[7]。本课题采用的家庭签约模式下的延续护理，包括抚触、心理疏导、康复护理等多项个体化整体护理服务。本研究选取于南昌大学第四附属医院肾内科就诊的60例血液透析RLS患者作为研究对象，探讨家庭签约模式下的延续护理在尿毒症血液透析血液透析RLS患者中的应用效果，旨在为开辟防治尿毒症性周围神经病变、改善RLS的新途径提供依据，现报道如下。, http://www.100md.com(叶钒 徐璐 邹德凤 周阳)
[关键词]尿毒症;血液透析;不宁腿综合征;护理
[中图分类号] R658.3 [文献标识码] A [文章编号] 1674-4721(2019)10(c)-0177-04
[Abstract] Objective To explore the application effect of continuous nursing care under family contract mode on uremic hemodialysis patients with restless leg syndrome (RLS)， in order to provide basis for better carrying out family contract， standardizing continuous nursing and opening up new ways of improving RLS nursing. Methods A total of 60 hemodialysis patients with RLS admitted to the department of nephrology of the Fourth Affiliated Hospital of Nanchang University from January 2016 to December 2017 were selected as the study subjects. They were divided into experimental group and control group by random number table method， with 30 patients in each group. Patients in the control group were treated with routine care of uremia hemodialysis， and patients in the experimental group were given continuous nursing care under family contract mode on the basis of routine care of uremia hemodialysis. The nursing effect after 6 months of nursing and sleep quality before and after nursing were compared between the two groups. Results The total effective rate of nursing in the experimental group was 93.33%， which was significantly higher than that of the control group (63.33%)， the sleep quality scale score in the experimental group was lower than that in the control group， the differences were statistically significant (P<0.05). Conclusion On the basis of the routine nursing of uremia hemodialysis， the continuous nursing under the family contract mode has a good effect on the improvement of clinical symptoms， signs and sleeping quality of uremic hemodialysis patients with RLS and thus has greatly improved their living quality.
[Key words] Uremia; Hemodialysis; Restless leg syndrome; Nursing
不寧腿综合征(restless leg syndrome，RLS)是尿毒症维持性血液透析患者一种严重的神经系统并发症，发病率为20%～40%，主要表现为睡眠期间发生非痛性、非痉挛性腿部不适，已严重影响了患者的睡眠及生活质量[1-2]。现有的针对尿毒症血液透析RLS患者的治疗措施只有血液净化及使用药物内科保守治疗(神经营养、改善血管微循环、促进毒素从体内排除等)，至今缺乏特异性病因疗法[3-4]，如何改善RLS已成为医护研究的重点。家庭医生签约服务是指居民自由选择社区医生并自愿签订服务协议，享受社区卫生服务团队为其提供的医疗健康管理服务[5]。转变医疗卫生服务模式，实行家庭医生签约服务，是深化医药卫生体制改革的重要任务，也是新形势下更好维护人民群众健康的重要途径[6]。研究表明，通过个性化的整体护理可使患者在生理、心理、社会等等方面达到最愉快的状态，减轻患者不适感，促进患者康复[7]。本课题采用的家庭签约模式下的延续护理，包括抚触、心理疏导、康复护理等多项个体化整体护理服务。本研究选取于南昌大学第四附属医院肾内科就诊的60例血液透析RLS患者作为研究对象，探讨家庭签约模式下的延续护理在尿毒症血液透析血液透析RLS患者中的应用效果，旨在为开辟防治尿毒症性周围神经病变、改善RLS的新途径提供依据，现报道如下。, http://www.100md.com(叶钒 徐璐 邹德凤 周阳)