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PBL模式对慢性肾衰竭合并糖尿病行血透患者的疼痛度和毒素清除的改善作用
作者:杜爽1  王秀丽2 
单位:1. 新疆维吾尔自治区人民医院 肾病科, 新疆 乌鲁木齐 830001;
2. 新疆维吾尔自治区人民医院米东医院 护理部, 新疆 乌鲁木齐 830021
关键词:PBL模式 慢性肾衰竭 糖尿病 毒素 生活质量 
分类号:R472.3
出版年·卷·期(页码):2018·46·第八期(947-952)
摘要:

目的:探究PBL模式对慢性肾衰竭合并糖尿病行血透患者的疼痛度和毒素清除的改善作用。方法:选取2015年1月至2017年1月期间在我院接受诊治的118例慢性肾衰竭合并糖尿病患者,随机分成PBL组与对照组,每组59例患者。其中,对照组行常规护理模式,PBL组给予PBL教育模式。结果:PBL组患者的重度焦虑和重度抑郁的比例分别为3.39%、1.69%显著的低于对照组的11.86%、13.56%,总体比较,PBL组患者的情绪显著优于对照组,有统计学意义(P<0.05)。组间比较,治疗后研究组患者VAS评分明显较干预前有明显降低,PBL组为(2.16±1.22)分,对照组为(4.83±1.76)分,两组比较差异显著(P<0.05)。两组治疗前脂肪因子、脂联素、抵抗素及炎症因子(Leptin、1L-6、TNF-a)比较无统计学意义(P>0.05),治疗后两组较治疗前比较均有改善效果,和对照组比较,PBL组效果显著(P<0.05)。血糖指标比较显示,两组患者空腹血糖(FBG)、餐后2 h血糖(2hPBG)、甘油三脂(TG)、总胆固醇(TC)均优于治疗前,但PBL组效果更佳。两组差异具有统计学意义(P<0.05)。另外,PBL患者的生活质量显著高于对照组,有统计学意义(P<0.05)。结论:PBL教育模式对糖尿病合并肾功能衰竭患者的体内毒素清除、血糖控制等具有一定的作用,明显降低患者因透析带来的疼痛度并显著的保证和改善患者的生活质量和负面情绪。

Objective:To explore the effect of PBL model on the pain and toxin clearance in patients with chronic renal failure and diabetes with hemodialysis. Methods:118 patients with chronic renal failure and diabetes mellitus who were treated in our hospital from January 2015 to January 2017, were randomly divided into PBL group and control group, 59 cases in each group.The control group received routine nursing, and the PBL group was given PBL education. Results:The rate of severe anxiety and severity of depression in PBL group were 3.39% and 1.69%, which were significantly lower than 11.86% and 13.56% in the control group. Compared with the control group, the mood of PBL group was significantly better than that of the control group(P<0.05). After treatment, the VAS score of the study group was significantly lower than that before intervention, that ofPBL group was (2.16±1.22), and that in the control group was (4.83±1.76), the difference was significant (P<0.05). Adipokines, adiponectin, resistin and inflammatory factor (Leptin, 1L-6, TNF-a) in the two groups had no statistical difference before treatment (P>0.05), after treatment the data were improved, however it was improved slightly in the control group, PBL group has a significant effect, the difference between the two groups had a statistical significance (P<0.05). The blood sugar index showed that after treatment fasting plasma glucose (FBG), 2 h fasting blood glucose (2Hpbg), triglyceride (TG) and total cholesterol (TC) were all better than those before treatment, but the effect of PBL group was better. The difference between the two groups was statistically significant (P<0.05). In addition, the life quality of patients with PBL was significantly higher than that of the control group (P<0.05). Conclusion:PBL education mode has a certain effect on toxin clearance and blood glucose control in diabetic patients with renal failure, and can significantly reduce the pain degree of patients due to dialysis, and improve the quality of life and negative emotions of patients.

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