Discussion on precision nursing strategy of fluid balance management in critically ill hemodialysis patients
重症血液透析患者液体平衡管理的精准护理策略探讨

摘要

目的 探究重症血液透析患者液体平衡管理中精准护理策略的应用效果。方法 选取2024年1月到2025年1月期间我院肾内科及重症医学科符合严格标准的80例重症血液透析患者作为研究对象。采用随机数字表法将其分为对照组和实验组，每组各40人。对照组采用常规液体平衡护理措施，实验组实施精准护理策略。结果 实验组患者液体平衡达标率为85.0%（34/40），显著高于对照组的62.5%（25/40）（χ²=5.231，P=0.022）；实验组并发症发生率为10.0%（4/40），明显低于对照组的27.5%（11/40）（χ²=4.021，P=0.045）；实验组患者透析后血尿素氮（BUN）、血肌酐（Scr）水平分别为（15.2±3.1）mmol/L、（356.8±52.4）μmol/L，显著低于对照组的（19.8±3.6）mmol/L、（428.5±61.7）μmol/L，差异均有统计学意义（t=5.872，P=0.000；t=5.436，P=0.000）。结论 在重症血液透析患者液体平衡管理中应用精准护理策略，可显著提高液体平衡达标率，降低并发症发生率，改善患者肾功能指标，具有重要的临床应用价值，值得推广。

Abstract

Objective To explore the application effect of precise nursing strategies in fluid balance management for critically ill hemodialysis patients.
Methods A total of 80 critically ill hemodialysis patients who met strict criteria in the Department of Nephrology and Intensive Care Unit of our hospital from January 2024 to January 2025 were selected as research objects. They were divided into control group and experimental group by random number table method, with 40 cases in each group. The control group received routine fluid balance nursing measures, while the experimental group implemented precise nursing strategies.
Results The fluid balance compliance rate in the experimental group was 85.0%(34/40),which was significantly higher than 62.5%(25/40)in the control group, with a statistically significant difference(χ²=5.231,P=0.022).The complication rate in the experimental group was 10.0%(4/40),which was significantly lower than 27.5%(11/40)in the control group, with a statistically significant difference(χ²=4.021,P=0.045).The levels of blood urea nitrogen(BUN)and serum creatinine(Scr)in the experimental group after dialysis were(15.2±3.1)mmol/L and(356.8±52.4)μmol/L, respectively, which were significantly lower than those in the control group[(19.8±3.6)mmol/L and(428.5±61.7)μmol/L],with statistically significant differences(t=5.872,P=0.000;t=5.436,P=0.000).
Conclusion   The application of precise nursing strategies in fluid balance management for critically ill hemodialysis patients can significantly improve the fluid balance compliance rate, reduce the incidence of complications, and improve renal function indicators of patients. It has important clinical application value and is worthy of promotion.