规律门诊随访对腹膜透析患者高血压控制率及相关疾病转归影响的回顾性分析

doi:10.16460/j.issn1008-9969.2021.10.011

护理学报 ›› 2021, Vol. 28 ›› Issue (10): 11-16.doi: 10.16460/j.issn1008-9969.2021.10.011

规律门诊随访对腹膜透析患者高血压控制率及相关疾病转归影响的回顾性分析

刘丹阳^1a,2, 艾军^1a, 李丹^1a,2, 廖生武^1b, 朱清瑶^1a,2, 龚妮容^1a, 张婷婷^1a, 张广清^1c

1.南方医科大学南方医院 a.肾内科; b.门急诊片区党总支; c.院办公室,广东广州 510515;
2.南方医科大学护理学院,广东广州 510515

收稿日期:2020-10-24 出版日期:2021-05-25 发布日期:2021-06-09
通讯作者: 张广清（1966-）,女,湖南湘潭人,本科学历,硕士研究生导师,主任护师。E-mail:HLBZhang@126.com
作者简介:刘丹阳（1995-）,女,河北保定人,本科学历,硕士研究生在读,护士。
基金资助:
广东省省级科技计划项目（2020A1414040021）; 南方医科大学护理科研专项（Z2019003）

Effect of Regular Outpatient Follow-up on Hypertension Control and Disease Outcome in Patients Undergoing Peritoneal Dialysis: A Retrospective Cohort Study

LIU Dan-yang^1a,2, AI Jun^1a, LI Dan^1a,2, LIAO Sheng-wu^1b, ZHU Qing-yao^1a,2, GONG Ni-rong^1a, ZHANG Ting-ting^1a, ZHANG Guang-qing^1c

1a. Dept. of Nephrology; 1b. General Party Branch of Outpatient and Emergency; 1c. Administrating Office, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
2. School of Nursing, Southern Medical University, Guangzhou 510515, China

Received:2020-10-24 Online:2021-05-25 Published:2021-06-09

摘要/Abstract

摘要： 目的探究规律门诊随访对腹膜透析患者高血压控制率、高血压相关疾病转归、高血压相关可控因素的影响。方法纳入2009年1月—2019年12月在本中心置管并随访的腹膜透析患者,查阅病历收集患者基线资料、血压资料和相关疾病的记录;调查研究截止时仍未退出腹膜透析的患者高血压相关可控因素。据随访频率分为规律随访组（≥1次/3月）和非规律随访组（<1次/3月）,比较2组的高血压控制情况。结果本研究共纳入526例腹膜透析患者,规律门诊随访率为52.3%。规律随访是腹膜透析患者高血压控制的独立影响因素（OR=1.705,95%CI：1.090~2.666,P=0.019）。规律随访与高血压相关疾病转归（退出腹膜透析、心血管疾病、心力衰竭）的发生无影响。规律随访改善了高血压相关可控因素。结论规律门诊随访是改善腹膜透析患者的高血压控制情况的有效手段,应不断提高随访的质量,鼓励患者定期进行门诊随访。

关键词: 门诊随访, 腹膜透析, 高血压, 回顾性队列研究

Abstract: Objective To explore the influence of regular outpatient follow-up on hypertension control rate, related diseases outcome and related controllable factors in patients with peritoneal dialysis. Methods Patients with peritoneal dialysis receiving catheterization and follow-up from January 2009 to December 2019 were included. According to the follow-up frequency, they were divided into regular follow-up group (≥once per 3 months) and irregular follow-up group (<once per 3 months). A retrospective cohort study was performed to access the general information, blood pressure data and related disease records of patients in the medical records. The related controllable factors of hypertension were investigated in patients who had not withdrawn from the study at the end of the study. Results A total of 526 patients with peritoneal dialysis were included in this study. The regular follow-up rate was 52.3%. Regular outpatient follow-up was an independent influencing factor for hypertension control in patients with peritoneal dialysis (OR=1.705, 95%CI=1.090~2.666,P=0.019) and was not associated with the occurrence of hypertension-related diseases (withdrawal from peritoneal dialysis, cardiovascular disease and heart failure). Regular outpatient follow-up also improved related controllable factors of hypertension. Conclusion Regular outpatient follow-up is an effective approach to improve the control of hypertension in patients with peritoneal dialysis. The quality of follow-up should be improved, and patients are encouraged to make regular outpatient follow-up.

Key words: outpatient follow-up, peritoneal dialysis, hypertension, retrospective cohort study

中图分类号:

R459.5

刘丹阳, 艾军, 李丹, 廖生武, 朱清瑶, 龚妮容, 张婷婷, 张广清. 规律门诊随访对腹膜透析患者高血压控制率及相关疾病转归影响的回顾性分析[J]. 护理学报, 2021, 28(10): 11-16.

LIU Dan-yang, AI Jun, LI Dan, LIAO Sheng-wu, ZHU Qing-yao, GONG Ni-rong, ZHANG Ting-ting, ZHANG Guang-qing. Effect of Regular Outpatient Follow-up on Hypertension Control and Disease Outcome in Patients Undergoing Peritoneal Dialysis: A Retrospective Cohort Study[J]. Journal of Nursing, 2021, 28(10): 11-16.

参考文献

[1] Saran R, Robinson B, Abbott KC, et al.US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States[J].AmJKidney Dis,2020,75(1 Suppl 1):A6-A7.DOI:10.1053/j.ajkd.2019.09.003.
[2] 韩庆烽. 北京地区腹膜透析中心管理水平评价体系建设与实施[J].中国血液净化,2020,19(9):614-617. DOI:10.3969/j.issn.1671-4091.2020.09.010.
[3] 何佩佩,殷晓红,夏银燕,等. 新型冠状病毒肺炎疫情时期腹膜透析患者远程管理的策略[J].中华护理杂志,2020,55(S1):299-301.DOI:10.3761/j.issn.0254-1769.2020.S1.110.
[4] Pajek J.Overcoming the Underutilisation of Peritoneal Dialysis[J]. Biomed Res Int,2015, 2015:431092. DOI:10.1155/2015/431092.
[5] 胡锦锦,熊飞,万胜,等. 首年门诊随访频率和维持性腹膜透析患者预后的相关性研究[J].临床肾脏病杂志,2020,20(4):270-276,286.DOI:10.3969/j.issn.1671-2390.2020.04.002.
[6] 苏春燕,谢一萍,路潜,等. 腹膜透析患者门诊随访率及其相关因素分析[J].中华护理杂志, 2009,44(11):976-978.DOI:10.3761/j.issn.0254-1769.2009.11.005.
[7] 蔡青利,蔡明玉,吴兴兰. 腹膜透析患者定期规律回院随访对透析质量的影响[J].齐鲁护理杂志,2016,22(15):84-85.DOI:10.3969/j.issn.1006-7256.2016.15.042.
[8] Vaios V, Georgianos PI, Liakopoulos V, et al.Assessment and Management of Hypertension among Patients on Peritoneal Dialysis[J]. ClinJAm Soc Nephrol,2018.DOI:10.2215/CJN.07480618.
[9] 中国医师协会肾脏内科医师分会,中国中西医结合学会肾脏疾病专业委员会. 中国肾性高血压管理指南2016(简版)[J].中华医学杂志,2017, 97(20):1547-1555.DOI:10.3760/cma.j.issn.0376-2491.2017.20.010.
[10] Wang AY, Brimble KS, Brunier G, et al.ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I - Assessment and Management of Various Cardiovascular Risk Factors[J]. Perit Dial Int,2015,35(4):379-387.DOI:10.3747/pdi.2014.00279.
[11] Zhang X, Shou Z, Chen Z, et al.The Role of an Integrated Care Model for Kidney Disease in the Development of Peritoneal Dialysis: A Single-center Experience in China[J].Perit Dial Int,2014, 34(Suppl 2):S55-S58.DOI:10.3747/pdi.2013.00124.
[12] 田素革,丁建平,郑艳平,等. 以专科护士为主导的多学科网络管理在腹膜透析患者中的应用[J]. 中华现代护理杂志,2020, 26(4):518-522.DOI:10.3760/cma.j.issn.1674-2907.2020.04.018.
[13] Shubayra A.Continuous Ambulatory Peritoneal Dialysis: Nurses’ Experiences of Teaching Patients[J].SaudiJKidney Dis Transpl, 2015, 26(2):309-313.DOI:10.4103/1319-2442.152491.
[14] 罗怡欣,黄燕林. 腹膜透析患者自我管理能力现状及其影响因素分析[J].护理管理杂志,2019,19(1):11-15.DOI:10.3969/j.issn.1671-315x.2019.01.003.
[15] 王吉英,肖光青,王彦,等. 社区糖尿病患者自我管理现状和护理指导需求的影响因素分析[J]. 中华现代护理杂志,2020, 26(15):2061-2065.DOI:10.3760/cma.j.cn115682-20190826-03056.
[16] 高芳,王少清,马欣,等. 血压控制对腹膜透析终末期肾病患者残余肾功能及透析充分性的影响[J]. 解放军医药杂志, 2020, 32(4):64-67.DOI:10.3969/j.issn.2095-140X.2020.04.016.
[17] 中国高血压防治指南修订委员会,中国高血压联盟,中华医学会心血管病学分会中国医师协会高血压专业委员会,等. 中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56.DOI:10.3969/j.issn.1007-5410.2019.01.002.
[18] Jennings JR, Heim AF.From Brain to Behavior: Hypertension’s Modulation of Cognition and Affect[J]. IntJHypertens,2012,2012:701385.DOI:10.1155/2012/701385.
[19] 倪兆慧,金海姣.中国腹膜透析发展70年[J].中国血液净化, 2019, 18(10):661-663.DOI:10.3969/j.issn.1671-4091.2019.10.001.
[20] 谌璐,刘云,尹飞挺,等. 持续质量改进在腹膜透析中心质量管理中的研究进展[J].护理研究,2015,29(32):3973-3975. DOI:10.3969/j.issn.1009-6493.2015.32.002.

Metrics

Viewed

Full text

Abstract

Cited

Shared

规律门诊随访对腹膜透析患者高血压控制率及相关疾病转归影响的回顾性分析

Effect of Regular Outpatient Follow-up on Hypertension Control and Disease Outcome in Patients Undergoing Peritoneal Dialysis: A Retrospective Cohort Study

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 10

[1]	厉柯轩, 沈利腾, 梁艺, 项薇旭, 应钰皑, 李玲. 高血压患者应用体验式健康教育的效果观察[J]. 护理学报, 2021, 28(3): 74-78.
[2]	张文艳, 刘于, 张梦. 低收入人群高血压患病现状与自我管理的研究进展[J]. 护理学报, 2020, 27(6): 12-16.
[3]	李苗苗, 安李一, 陆巍, 王娟, 徐鹏飞. Ⅳ型心肾综合征腹膜透析患者容量管理的最佳证据总结[J]. 护理学报, 2020, 27(22): 39-44.
[4]	龙烨, 沈秋, 龙琼, 梁燕冬, 陶秀凤, 周晓兰. 642例客家高血压患者服药依从性现状及影响因素分析[J]. 护理学报, 2020, 27(14): 40-43.
[5]	黄莺莺, 曹卫平, 韦嘉洁, 李妍. 妊娠期高血压疾病患者患病体验的质性研究[J]. 护理学报, 2020, 27(10): 5-9.
[6]	杨玉颖, 黄燕林, 刘玲玲, 罗怡欣. 信息-动机-行为技巧模型延伸服务对居家腹膜透析患者饮食行为的影响[J]. 护理学报, 2019, 26(20): 1-4.
[7]	刘娣. 314例肾性高血压患者感知益处与经验性回避的相关性分析[J]. 护理学报, 2019, 26(14): 47-50.
[8]	张灵幻, 徐鹏飞, 王娟. 294例维持性腹膜透析患者的应对疲惫现状及影响因素分析[J]. 护理学报, 2019, 26(1): 50-54.
[9]	陆柳营, 陈玲, 杨永, 傅桂芬, 韦玉娟, 王文广, 涂燕玉, 杨连招. 原发性老年高血压合并衰弱的研究进展[J]. 护理学报, 2018, 25(21): 19-23.
[10]	吕明花, 李申恒, 廖华, 杨梅艳, 朱艳. 感应式腹膜透析废液排出处理器的研制和应用[J]. 护理学报, 2018, 25(19): 77-78.
[11]	李明士,葛兆霞,许玲. 482例高血压患者出院准备度及影响因素分析[J]. 护理学报, 2018, 25(16): 34-38.
[12]	董婷,刘素珍,李继平. 四川省2931例社区老年高血压糖尿病患者护理服务的满意度及影响因素分析[J]. 护理学报, 2017, 24(9): 7-10.
[13]	张雪芳,陆舒婷,张敏,陈绍月,陈志亮,赵元媛. 时辰穴位贴敷对肝阳上亢型高血压病患者晨峰血压的影响[J]. 护理学报, 2017, 24(8): 48-51.
[14]	廖婧,黄柳燕,沈麒云,张卫红,龚晶. 翻转课堂在实习护生腹膜透析换液临床护理教学中的应用[J]. 护理学报, 2017, 24(3): 14-17.
[15]	林航,王爱红,王筱筱,段宏为. 南京市兰园社区高血压患者自觉健康控制现状及其影响因素分析[J]. 护理学报, 2017, 24(23): 32-36.