Study Of Relevant Factors And Nursing Care For Patients Of Sufficiently High Flux Hemodialysis (HFHD)

Hemodialysis(HD) is a basis of kidney replacement , high flux hemodialysis (HFHD)is one of permanently replaceable therapies for the patients who are treated by maintained hemodialysis (MHD)permanently.With the rapid development of synthetic membrane in the middle of eighties ,twenty century , HFHD was emerged ,it was the first time in nineties that we used HFHD in our country , to a great extent, the effect of HD for patients on MHD permanently was attributed to the methods of HD. Because DRA is a kind of common, severe and prospective complications of the patients who suffered from MHD permanently , effective HFHD can eliminate median molecule solute (MMS)—β2-MG with correspondent nursing care ,which can prevent from or prolong the incidence of prospective complications so that it is helpful to adjust the plan of HD practically. With further clinical research of HFHD and nursing care ,we have got good results that HFHD was applied to the patients who were on MHD permanently .The purpose of present study is to explore relevant factors and nursing care for the patients who are on MHD permanently in order to reduce the incidence of prospective complications and improve the rate of living and quality of life of the patients.In present study,46 patients of MHD permanently were randomlydivided into two groups from December 2006 1 to December 2007. 2 (23 in observation group under HFHD vs.23 in control group under low flux Hemodialysis ,LFHD).Control group was treated by conventional nursing while observation group was intervened in psychology ,learning and behavior besides conventional nursing .The results showed that :1.BUN and SCr after HD were significantly lower than that before HD, there was no statistical difference of Kt/v between two groups;2.There were no significant differences of the descending rate of serumβ2-MG before the first HD between two groups ,in aspect of eliminating median molecule solute (MMS), there were no significant differences of density of serumβ2-MG before and after first LFHD in control group, in correspondence with other reports, while there were significant differences of density of serumβ2-MG before and after first HFHD in observation group .The density of serumβ2-MG in observation group was significantly lower than that of control group ,the descending rate of that was(49.2±18.1)%,which indicated that there was significant differences of that between two groups and HFHD can eliminate serumβ2-MG to some extent .3.There were statistical differences of density of serumβ2-MG before and after HFHD when patients were treated after one month ,six months and one year in observation group. The density of serumβ2-MG was significantly lower in observation group than that of control group. 4.With different methods of HD after oneyear ,there were significant differences of incidence of clinical symptoms such as wrist pain, osteoneuralgia ,skin itching ,muscular pain etc.5.The effect of nursing in observation group was much better than that of control group .Conclusion : For the patients of MHD permanently ,the penetrating volume of synthetic membrane of HD is main factor to affect effective elimination of serumβ2-MG in order to eliminate large, median, small molecule poisons, especially monitor the level of serumβ2-MG in the body ,and indicate standard of MHD sufficiently. LFHD is increasingly replaced by HFHD in our country . HFHD is superior to traditional LFHD in its aspect of eliminating median and large molecule substance (MMS,LMS), meanwhile it is essential that skillful technique of nursing and careful observation for the patients guarantee to succeed, which trends the purification of blood in our country. Effective HFHD can eliminate MMS—β2-MG with correspondent nursing care ,which can prevent from or prolong the incidence of prospective complications so that it is helpful to adjust the plan of HD practically. The increase of elimination rate may reduce the incidence of prospective complications and improve the rate of living and quality of life of the patients who were on MHD permanently.