实用器官移植电子杂志 ›› 2020, Vol. 8 ›› Issue (3): 194-197.DOI: 10.3969/j.issn.2095-5332.2020.03.008

• 论著 • 上一篇    下一篇

专科护士主导的多学科团队模式在成人 DCD肾移植术后管理中的应用分析

李烟花,曹洁,陆小英,孟宪丽
  

  1. 海军军医大学附属长海医院器官移植科,上海 200433
  • 出版日期:2020-05-20 发布日期:2021-06-02
  • 基金资助:

    海军军医大学护理学高峰学科青年培育工程管理项目(18QPGL03);

    长海医院第三期护理科研立项项目 (2018HLMS09)

Practice and effectiveness of multidisciplinary team model led by specialized nurses in postoperativemanagement of adult DCD kidney transplantation

Li Yanhua,Cao Jie,Lu Xiaoying,Meng Xianli.    

  1. Department of Organ Transplantation,Changhai Hospital Affiliated to Naval Medical University,Shanghai 200433
  • Online:2020-05-20 Published:2021-06-02

摘要:

目的 探讨专科护士主导的多学科团队(multidisciplinary team,MDT)模式在成人心脏死亡 器官捐献(donation after cardiac death,DCD)肾移植术后管理中的实践与成效。 方法 回顾性分析某三甲 医院 2017 年 9 月— 2018 年 8 月收治的 118 例成人肾移植患者的临床资料,对照组给予常规术后护理,观 察组实施专科护士主导的 MDT 模式护理,比较两组患者术后导管护理相关并发症的发生情况,主要症状经 历及其困扰程度、肾移植护理质量情况。 结果 观察组术后经外周静脉穿刺中心静脉(peripherally inserted central venous catheters,PICC)置管、血透患者中心静脉导管、腹膜透析置管 3 类特殊导管护理的相关并发 症发生率较对照组低(P < 0.05),患者肾移植术后主要症状经历及困扰程度均较对照组低,肾移植术后护 理质量评分(基础护理落实率、并发症预警正确度、感染防控措施到位情况、健康教育掌握度及患者对护 理工作满意度)显著高于对照组,且差异具有统计学意义(P < 0.05)。 结论 在成人 DCD 肾移植术后管 理中采用专科护士主导的 MDT 模式可减少护理相关并发症,改善患者术后症状经历体验,促进临床护理质 量的提升,值得临床运用。

关键词: 专科护士 , MDT , 肾移植 , 管理

Abstract:

Objective To discuss the practice and effectiveness of the multidisciplinary team model led by specialized nurses in the post-surgery management of adult DCD kidney transplantation. Methods A retrospective study was performed in our center from September 2017 to August 2018 including 118 cases of adult renal transplant patients. The control group was given routine nursing,while the observation group received the MDT management led by specialized nurses. We recorded the nursing quality as well as the complications such as the catheter related complications and nursing related symptoms. Results The observation group suffered from lower incidence of catheter related complications(PICC catheter,central venous catheter,peritoneal dialysis catheter,P < 0.05), fewer and milder incident of the main complications and had a higher nursing quality score(primary care ,early warning of complications,infection control,health education,and patients satisfaction)than those of control group after renal transplantation(P < 0.05). Conclusion The MDT mode led by specialized nurses in the management of adult DCD kidney transplantation played a promising role in reducing nursing related complications,improving patient recovery and promoting the clinical nursing quality.

Key words: Specialized nurse, Multidisciplinary team, Kidney transplantation, Management