| Part 1Nutritional risk screening of maintenance hemodialysis patients in a tertiary hospitalObjective:Strengthen the reasonable nutritional intervention for maintenance hemodialysis(MHD)patients to improve the clinical outcome of such patients during hospitalization.Method:For MHD patients who were hospitalized in the nephrology department of the hospital from April 2019 to May 2020,nutrition risk screening for newly admitted MHD patients is done by nutritional support pharmacist(NSP)using the nutrition risk screening scale(NRS2002).Then collect the corresponding blood biochemical indicators and repeat screening for patients without nutritional risk at 7 days until they are discharged.Result:Among 102 screened patients,26.47%(27 cases)had nutritional risks,and43.13%(44 cases)had hyperphosphatemia;ANOVA showed that nutritional risk was correlated with albumin,blood phosphorus,hemoglobin,and age(all P<0.05);The risk of hyperphosphatemia is not positively correlated with nutritional risk and age(P< 0.05);Than it was related to hemoglobin,potassium and uremic nitrogen were positively correlated(P<0.05).Conclusion:The NRS2002 scale is suitable for patients with MHD,but patients with MHD are at greater risk of hyperphosphatemia.NSP should cooperate with the clinic to do a good job of nutritional risk screening for patients with MHD during hospitalization,and attention should be paid to patients with hyperphosphatemia and guidance the use of clinical nutritional preparations and drugs.Part 2Explore the effect of azotemia on the occurrence of hyperphosphatemia in MHD patientsObjective:Retrospective investigation of maintenance hemodialysis(MHD)patients with high incidence.Method:Taking the patients who attended the outpatient clinic of the blood purification center of the hospital from January 2019 to June 2020 as the study subject,the patient’s clinical disease diagnosis is obtained from the doctor’s HIS system,and the relevant medical technical examination report is collected from the laboratory system.One-way analysis of variance and logistic regression analysis were used to explore the risk factors of hyperphosphatemia.Result:Nephropathy-related medical and technical laboratory results suggest that the disease-related index values of the hyperphosphatemia group are higher than those of the non-hyperphosphatemia group.which were statistical differences in age,urea nitrogen,creatinine,potassium,and uric acid between the two groups(P<0.05);ANOVA and logistic regression analysis indicated that the occurrence of hyperphosphatemia was significantly correlated with age,uremic nitrogen,potassium,creatinine,and uric acid(P<0.05).And creatinine and urea nitrogen are independent risk factors for hyperphosphatemia.Conclusion:Azotemia can increase the risk of hyperphosphatemia,and The clinic should focus on MHD patients with hyperazotemia in order to prevent the occurrence of hyperphosphatemia.Part 3Study on pharmaceutical care of maintenance hemodialysis with hyperphosphatemiaObjective:This study is based on the premise that clinical pharmacists’ individualized medication,follow-up,and service for patients in the clinic is to explore the advantages of the new model of clinical pharmacists’ intervention for patients with chronic diseases in the long-term treatment of maintenance hemodialysis patients,in order to reduce the complications of maintenance hemodialysis patientsMethod:Patients with MHD who were diagnosed and treated in the nephrology department of this hospital from May 2019 to November 2020 are the screening targets,than taking the MHD patients carry out conventional treatment and pharmaceutical care treatment respectively who with hyperphosphatemia were randomly divided into two groups as research subjects.The two groups of patients were treated with lanthanum carbonate chewable tablets and the Morisky Medication Adherence Scale(MAAS-8)was used for medication compliance assessment.Result:Comparison of treatment effects between the two groups: the treatment rates of the control group and the experimental group were 47.36% and 89.47%,respectively.Comparison of medical technical and biochemical indicators: the blood phosphorus level,urea nitrogen value,and calcium phosphorus product of patients changed before and after treatment;the blood phosphorus level and calcium phosphorus product of patients were different(P<0.05),and there was no statistical change in blood calcium level and urea nitrogen value;comparison of Morsky medication compliance: Only the experimental group had a statistically significant difference in the score of Morsky medication compliance after pharmaceutical care(P<0.05).Conclusion:Pharmaceutical care can benefit patients in the treatment of hyperphosphatemia,can effectively reduce the levels of blood phosphorus,calcium and phosphorus product,and improve patient compliance. |
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