摘要
目的探讨ORTCC管理模式在维持性血液透析(MHD)患者自体动静脉内瘘(AVF)血管维护中的临床效果及对预后的影响。方法选取2023年1月至2024年6月我院收治的MHD患者120例,随机分为对照组和观察组,每组60例。对照组实施常规护理;观察组采用ORTCC模式进行护理干预,通过以目标(Objective)、规则(Rules)、训练(Training)、考核(Check)、文化(Culture)为核心要素实施护理干预。比较两组干预前及干预6个月后的血管通路并发症(狭窄、血栓、感染)发生率、自我管理行为量表(SMSH)评分及肾脏疾病生存质量量表(KDQOL-SF)评分,以评估ORTCC模式的干预效果。结果对照组的血管通路并发症发生率为23.33%,观察组为8.33%,两组比较差异有统计学意义(P<0.05)。干预后,观察组的SMSH评分及KDQOL-SF评分均显著高于对照组,差异均有统计学意义(均P<0.05)。结论ORTCC模式通过系统化目标管理、标准化操作流程、规范化培训体系及多维考核机制,能够有效降低AVF并发症风险,提升患者自我管理能力和生存质量,为MHD患者血管通路维护的精细化护理提供循证依据。
Objective To investigate the clinical effect of the ORTCC management model in vascular maintenance of autogenous arteriovenous fistula(AVF)in maintenance hemodialysis(MHD)patients and its influence on prognosis.Methods A total of 120 patients with MHD admitted to our hospital from January 2023 to June 2024 were randomly divided into control group and observation group,with 60 cases in each group.The control group was given routine nursing care,while the observation group was given ORTCC mode.The nursing interventions was carried out by taking Objective,Rules,Training,Check and Culture as the core elements.The incidence of vascular access complications(stenosis,thrombosis,infection),Self-Management Scale for Hemodialysis(SMSH)scores,and Kidney Disease Quality of Life Short Form(KDQOL-SF)scores were compared between the two groups before the intervention and 6 months after the intervention to evaluate the effect of the ORTCC model.Results The incidence of vascular access complications was 23.33%in the control group,while that in the observation group was 8.33%.The difference between the two groups was statistically significant difference(P<0.05).After the intervention,the total SMSH score and KDQOL-SF score of the observation group were significantly higher than those of the control group,and the differences were statistically significant(all P<0.05).Conclusion Through systematic target management,standardized operational process,standardized training system,and multidimensional assessment mechanisms,the ORTCC model can effectively reduces the risk of AVF complications,improve patients′self-management ability and quality of life,and provide evidence-based basis support for refined nursing in vascular access maintenance for MHD patients.
作者
王娟
刘伟宸
吴卓媚
王誉华
李小玲
黄爱芳
WANG Juan;LIU Weichen;WU Zhuomei;WANG Yuhua;LI Xiaoling;HUANG Aifang(Department of Blood Purification,First Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi Zhuang Autonomous Region,530021,China)
出处
《蛇志》
2025年第2期235-239,247,共6页
Journal of Snake
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(项目名称:基于ORTCC模式管理的血管通路小组在MHD患者血管通路维护中的应用,项目编号:Z-A20230576)。
