| 方妮娜,章海芬.维持性血液透析患者基于BCM的目标式容量管理效果的研究[J].上海护理,2025,25(9): |
| 维持性血液透析患者基于BCM的目标式容量管理效果的研究 |
| A study on the effectiveness of BCM based targeted volume management in maintenance hemodialysis patientsFangnina,zhanghaifen,taoxingjuan,shilling,linhuining,lailanshuhui. |
| 投稿时间：2024-06-18 修订日期：2025-08-21 |
| DOI： |
| 中文关键词: 血液透析 容量负荷 目标管理 |
| 英文关键词:Maintenance Hemodialysis Capacity load Goal management |
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| 中文摘要: |
| 摘要：目的 评价基于人体成分分析（BCM）的目标式容量管理在维持性血液透析（MHD）患者中的应用效果。方法 2019年12月至2020年5月，采用方便抽样的方法选取上海交通大学医学院附属仁济医院透析中心125例MHD患者作为研究对象。按透析班次将其分为观察组（n=62）和对照组（n=63）,观察组以水负荷（OH）/细胞外液（ECW）比值10%～15%作为容量管理目标，与患者制订协议目标和行动计划，并定期反馈；对照组以透析间期体重增长＜干体重5%作为容量管理目标。比较两组基线及干预6个月后的OH/ECW比值及比值达标率，透析前血压、脑钠肽和透析间期体重增长达标率。结果 干预6个月后，两组患者OH/ECW比值（0.13±0.04 vs 0.22±0.11，P=0.001）、OH/ECW比值达标率（42.83% vs 16.72%，P=0.04）、透析前血压达标率（18.11% vs 11.72%，P=0.01）、透析间期体重增长达标率（26.22% vs 2.81%，P=0.01）、透析前脑钠肽达标率（72.12% vs 50.03%，P=0.04）比较，差异均有统计学意义（P＜0.05）。结论 基于BCM的目标式容量管理可作为MHD患者的液体管理方法，能提高患者透析间期体重增长达标率和血压达标率，有效改善患者容量平衡，进而提高患者生活质量水平。 |
| 英文摘要: |
| Objective The purpose of this study is to evaluate the effectiveness of targeted volume management in maintenance hemodialysis (MHD) patients based on BCM evaluation. Methods This study adopts a quasi experimental design and is divided into an intervention group and a control group according to the dialysis schedule. The intervention group set a volume management goal of 10% -15% OH (overhydration, OH)/ECW (extracellar water, ECW) ratio, and established protocol goals and action plans with patients, with regular feedback; The control group set a volume management goal of 3% -5% difference between pre penetration weight and dry weight. Compare the baseline and 6-month intervention OH/ECW ratio and ratio compliance rate between two groups, as well as the pre dialysis blood pressure compliance rate, brain natriuretic peptide compliance rate, and post dialysis body weight compliance rate. Results A total of 128 MHD patients were included in this study; Among them, 3 patients (4.7%) died due to cardiovascular complications during the intervention, and a total of 125 patients completed the intervention and were included in the result analysis. After 6 months of intervention, there were significant differences in the OH/ECW ratio (0.13 ± 0.04 vs 0.22 ± 0.11, P=0.001), OH/ECW ratio compliance rate (42.8% vs 16.7%, P=0.04), pre dialysis blood pressure compliance rate (18.0% vs 11.7%, P=0.01), pre dialysis body weight compliance rate (26.2% vs 2.8%, P=0.01), and BNP compliance rate (72.1% vs 50%, P=0.04) between the intervention and control groups, and the differences were statistically significant. Conclusion Targeted capacity management based on BCM for MHD patients can effectively improve patient capacity balance and improve their quality of life. |
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