尿毒癥患者院內自動化腹膜透析報警原因分析及護理對策

曹芳 李嵐緋 林欽玉

[摘要] 目的 探討護士在正確分析腹膜透析機的報警原因，及時進行處理的情況下，護理措施對患者的治療是否安全有效。方法 方便選取在2018年11月—2019年5月之間需要進行自動化腹膜透析機治療的尿毒癥患者135例，用隨機數字法將患者分為A組及B組，患者均其中A組65例，男39例，女26例;B組70例，男43例，女27例，兩組患者在性別、年齡、透析總月、平均上機時間、教育水平及報銷方式差異無統計學意義（P>0.05），對比兩組患者使用APD時報警的種類及次數。 結果 兩組患者總報警頻率為16.08%與12.03%，差異無統計學意義（χ2=1.408，P=0.235），在疼痛、引流不暢、腹脹等報警項目A組發生頻率為1.51%、6.53%、2.51%，B組為0.93%、7.87%、1.40%，兩組差異無統計學意義（χ2=0.294、0.276、0.692，P>0.05），治療期間無發生嚴重并發癥，腹膜透析相關感染并發癥，如腹膜透析出口感染、隧道感染、腹膜炎，同時未出現腹膜透析漂管現象。結論 正確分析腹膜透析機的報警原因，及時進行處理，護理措施及時有效，自動化腹膜透析機治療對患者是安全的，治療是有效的，可以預見的是家庭式自動化腹膜透析機有廣闊的發展空間，使更多的患者從中受益，做到真正意義的長程、高質量透析。

[關鍵詞] 尿毒癥;自動化腹膜透析;報警原因;護理對策

[中圖分類號] R4? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2020）06（b）-0157-03

[Abstract] Objective To explore whether nurses are safe and effective in the treatment of patients when they correctly analyze the cause of the alarm of the peritoneal dialysis machine and deal with it in time. Methods 135 patients with uremia who needed automatic peritoneal dialysis machine treatment between November 2018 and May 2019 were convenienty selected. The patients were divided into group A and group B by random number method， 39 males and 26 females; 70 people in group B， 43 males and 27 females. There were no statistically significant differences in gender， age， total dialysis month， average time on board， education level， and reimbursement methods for the two groups of patients（P>0.05）. Types and frequency of alarms when patients in the two groups use APD. Results The total alarm frequency of the patients in the two groups was 16.08% and 12.03%， there was no significant difference （χ2=1.408， P=0.235）， and the frequency of the alarm group A was 1.51% and 6.53%，2.51% in the alarm items such as pain， poor drainage， and bloating， 0.93%， 7.87%， 1.40% in group B， no significant difference between the two groups （χ2=0.294，0.276，0.692， P>0.05）， no serious complications occurred during treatment， and complications of peritoneal dialysis-related infections， such as peritoneal dialysis outlet infection， tunnel infection， peritonitis， and there is no peritoneal dialysis drift tube phenomenon. Conclusion The cause of the alarm of the peritoneal dialysis machine is correctly analyzed， and the treatment measures are timely and effective. The automatic peritoneal dialysis machine treatment is safe for the patient and the treatment is effective. It is foreseeable that the home-style automatic peritoneal dialysis machine has a broad development space， so that more patients benefit from it， to achieve a truly long-term， high-quality dialysis.

[Key words] Uremia; Automated peritoneal dialysis; Alarm causes; Nursing strategies

自動化腹膜透析（APD）是利用腹膜透析機進行自動腹膜透析換液的一種透析治療方式，夜間休息前，將腹膜透析管與機器相連，設定好透析參數，透析機自動進行透析液的灌入與引流，電腦系統會記錄所有的透析參數如灌入量、超濾量、引流時間、留腹時間等[1]。APD治……