降低血液透析病人透析間體重增加超過乾體重5%之改善專案

A Project for Controlling the Interdialytic Weight Gain Less Than 5% of Dry Weight for the Hemodialysis Patients

吳淑華(Shu-Hua Wu) ； 戴秀珍(Hsiu-Chen Tai) ； 周郁文(Yu-Wen Chou) ； 張純純(Chun-Chun Chung) ； 蔡麗紅(Li-Hung Tsai)

《長庚護理》 26卷1期 (2015/03) Pp. 41-52

https://doi.org/10.3966/102673012015032601005

摘要

血液透析病人控制透析間的體重增加在乾體重5%以下是很重要的，以預防透析間高血壓及透析中低血壓。本專案目的在降低血液透析病人透析間體重超過乾體重5%，解決方案包括製作水分控制衛教手冊、製作小海報張貼在衛教欄、增訂透析護理衛教標準規範、增訂水分控制護理計劃單、舉辦在職教育訓練、舉辦腎友座談會及增購身體成分分析儀評估乾體重。專案改善後病人透析間體重增加超過乾體重5%由37.26%下降至19.67%，在透析中發生合併症由20.18%下降至10.36%，達到專案的目的，而透析前血壓＞150/90mmHg由17.72%下降至15.09%，雖然未達到專案的設定目標，但是有下降的情形。因為衛教實施成效良好，將作業流程標準化。期望本專案的經驗提供其他透析院所之照護指引。

關鍵字

血液透析 ； 乾體重 ； 身體成分分析儀

並列摘要

The interdialytic weight gain less than 5% of dry weight for the hemodialysis patients is thought to be important in the prevention of interdialytic hypertension or intradialytic hypotension. The purpose of this project was to control the interdialytic weight gain less than 5% of dry weight for the hemodialysis patients. The resolutions included establishing medical brochures for fluid control, displaying posters on health bulletin board, creating standard nursing guidelines with regard to health education for hemodialysis care, providing in-service education program, holding medical conferences with hemodialysis patients, and assessing dry weight with body composition monitor. The results showed that the percentage of patients with 5% or more of interdialytic dry weight dropped from 37.26% to 19.67%, the percetage of patients with pre-dialytic hypertension (＞150/90mmHg) fell from 17.72% to 15.09%, and the percentage of patients with intradialytic complications decreased from 20.18% to 10.36%. The project has provided successful example about standardize clinical nursing care protocol for the care provider. We want to share this experience to other hemodialytic units as a guide to improve their quality of care.

並列關鍵字

hemodialysis ； dry weight ； body composition monitor

參考文獻

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