Abstract: Objective: To explore the effect of stratified case management on maintaining self -management ability and quality of life in patients with chronic kidney disease undergoing maintenance hemodialysis. Methods: A total of 96 cases of patients with chronic kidney disease undergoing maintenance hemodialysis(MHD) were included from January 2021 to December 2021.The patients were divided into observation group (n=48）and control group (n=48）by random number table. The control group received routine nursing intervention. The observation group received stratified case management. The improvement of self-management ability and quality of life in two groups before intervention and after 3 months intervention were compared. The occurrence of adverse events of hemodialysis during the 3 -month follow -up of two groups were recorded. Results: The MHD Self-Management Behavior Scale(SMSH) score and Brief Health Status Scale (SF -36) related dimension scores of the observation group were significantly higher than the control group after intervention (P<0.05). The incidence of hemodialysis adverse events of the observation group were significantly lower than the control group during the follow-up period(P<0.05). Conclusion: Stratified case management can effectively improve the self -management ability of patients with chronic kidney disease undergoing MHD, reduce the occurrence of hemodialysis adverse events, and improve the quality of life of patients.

Key words: Stratified case management, Maintenance hemodialysis, Self-management ability, Adverse events, Quality of life

摘要： 目的：探讨分层个案管理对慢性肾病维持血液透析（MHD）患者自我管理能力及生活质量的影响。方法：2021 年 1 月至 12 月选取慢性肾病 MHD 患者 96 例为研究对象，应用随机数字表将患者分为观察组及对照组各 48 例。对照组给予常规性护理干预，观察组给予分层个案管理，比较两组干预前及干预 3 个月自我管理能力及生活质量改善情况，并记录两组随访 3 个月血液透析并发症发生情况。结果：观察组干预后 MHD 自我管理行为量表（SMSH）总分及简明健康状况量表（SF-36）各维度评分均高于对照组，差异有统计学意义（P<0.05）。随访期间观察组血液透析并发症发生率低于对照组，差异有统计学意义（P<0.05）。结论：分层个案管理能有效提高慢性肾病 MHD 患者自我管理能力，降低患者血液透析并发症发生，改善患者生活质量。

关键词: 分层个案管理, 维持血液透析, 自我管理能力, 并发症, 生活质量