目的：观察安神热奄包联合血液透析滤过对睡眠障碍血透患者睡眠质量、透析质量、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor alpha,TNF-α)的影响。 方法：将60例维持性血液透析同时存在睡眠障碍的患者,按照随机数字表法分为研究组和对照组各30例,对照组给予心理护理和基础血液净化治疗,研究组在心理护理基础上,每周进行3次血液透析滤过(Hemodiafiltration,HDF)治疗以及3次安神热奄包足浴。两组患者均治疗2个月。比较两组患者干预前、后的匹兹堡睡眠质量指数评分(Pittsburgh sleep quality index,PSQI)、尿素清除指数评分(K-T/V)、hs-CRP、IL-6、TNF-α指标。 结果：(1)干预前,两组患者的PSQI评分、K-T/V评分、hs-CRP、IL-6、TNF-α指标比较,差异均无统计学意义(P＞0.05)；(2)干预后,两组患者的K-T/V评分均较干预前提高(P＜0.05),两组患者的PSQI评分、hs-CRP、IL-6、TNF-α指标均较干预前降低(P＜0.05)；(3)干预后,研究组的K-T/V评分高于对照组(P＜0.05),研究组的PSQI评分、hs-CRP、IL-6、TNF-α指标均低于对照组(P＜0.05)。 结论：安神热奄包联合血液透析滤过可以明细改善血透患者的睡眠质量、透析质量和免疫微炎症状态。
Objective：To observe the effects of the combination of calming foot bath and hemodialysis on sleep quality,dialysis quality,hypersensitive c-reactive protein(hs-CRP),interleukin-6 (IL-6)and tumor necrosis factor alpha (TNF-α)in patients with sleep disorders. Methods：According to the random number table method,60 patients with maintenance hemodialysis and sleep disorder were divided into study group and control group,30 cases each. The control group was given psychological nursing care and basic blood purification treatment.The team on the basis of psychological nursing,3 times per week Hemodiafiltration (HDF) treatment and calming foot bath. Both groups were treated for 2 months. The PSQI score,K-T/V score,hs-CRP,IL-6 and TNF-α of the two groups before and after intervention were compared. Results：(1)Before intervention,the PSQI score,K-T/V score ,hs-CRP,IL-6 and TNF-α of the two groups of patients were compared,and the differences were not statistically significant(P＞0.05)；(2)After intervention,K-T/V score of patients in both groups was higher than that before intervention(P＜0.05)；the PSQI score ,hs-CRP,IL-6 and TNF-α of patients in both groups were lower than that before intervention(P＜0.05)；(3)After intervention,K-T/V score of the study group was higher than that of the control group (P＜0.05)；the PSQI score ,hs-CRP,IL-6 and TNF-α of the study group were lower than that of the control group(P＜0.05). Conclusion：The combination of calming foot bath and hemodiafiltration can improve the sleep quality,dialysis quality and immune function of hemodialysis patients.