Research Of Clinical Application Of Triangle Chronic Disease Layer Management Model In Patient With Uremia Hemodialysis

[Objective] ①Reference Triangle chronic disease stratified hierarchical management model suitable for uremia patients with maintenance hemodialysis stratified hierarchical management model. ②On patients with maintenance hemodialysis stratified hierarchical management model of blood pressure in patients with uremia hemodialysis clinics, dialysis adequacy, calcium phosphate metabolism, anxiety, depression score, the influence of social support.[Method] Reference Triangle chronic disease stratified hierarchical management model suitable for uremia patients with maintenance hemodialysis hierarchical classification management model. Selected on September 1,2014-September 1,2015 in the first affiliated hospital of guangxi medical university of blood purification, conform to the inclusion criteria, signed informed consent outpatient blood dialysis patients, by the sample size estimation, eventually selected 140 cases, according to the computer generated random number table, divided into the experimental group and the control group (n=70). Experimental group:with reference to the blood purification standard operating procedures (2010 edition)\"into the regular dialysis, nurse uremia patients with maintenance hemodialysis layered classification as defined by the management model of outpatient dialysis patients into management, first of all to patients with layered, divided into intensive, smooth high-risk layer and layer 3 levels, and provide the corresponding level of intervention, the secondary intervention and three-level intervention in three levels of care; Control group:reference to blood purification standard operating procedures (2010 edition) into routine dialysis, nurse the patients into sexual 1-2 times a month, telephone follow-up family visit when necessary, and during the dialysis treatment into the evaluation and the corresponding health education; Two groups of intervention time is 6 months. Compared two groups of patients before and after the intervention of blood pressure, dialysis adequacy, calcium phosphorus metabolism, anxiety, depression scores and social support level, all data using SPSS22.0 statistics software to analysis and processing of measurement data with mean standard deviation, said count data expressed in the median, measurement data between the two groups compared with t test, counting data by chi-square test, repeated measurement of measurement data with repeated measurements analysis of variance, etc.[Results] ①On peritoneal dialysis Triangle chronic disease stratified hierarchical management model construction of uremia hemodialysis patients stratified hierarchical management model. ②Two groups of patients before and after the intervention, the experimental group the systolic pressure, diastolic pressure drops more ideal were 134.51±7.35,85.63±8.04 (P<0.05); Potassium, phosphorus levels better control level, were 4.14±0.46,4.14±0.32 (P<0.05); Dialysis adequacy index:urea decline rate (URR), urea clearance index (KT/V) fell more obvious, were 0.89±0.08,0.89±0.08 (P<0.05); Lower incidence of anxiety and depression incidence (P< 0.05), the difference of two groups of patients before and after the intervention had statistical significance (P<0.05).[Conclusion] ①Set of uremia patients with maintenance hemodialysis stratified hierarchical management model is feasible; ②Uremia hemodialysis outpatients stratified hierarchical management model to improve patients with uremia hemodialysis outpatient dialysis sufficiency; Reduce the calcium phosphate levels in patients with uremia hemodialysis clinic; To improve the high blood pressure in patients with uremia hemodialysis clinics; Reduce the dialysis patients with uremia hemodialysis clinics the incidence of symptomatic hypotension; Reduced the incidence of anxiety and depression in patients with uremia hemodialysis clinics; Improve patients with uremia hemodialysis outpatient social support. The Triangle in this chronic disease stratified hierarchical management model is scientific, simple, safe, economic and practical and effective characteristics, can be applied to uremia hemodialysis outpatients in the promotion and implementation.