糖尿病腹膜透析患者液体摄入健康信念及容量负荷状况研究

发布时间：2019-04-10 16:41

【摘要】：目的通过比较糖尿病腹膜透析与无糖尿病腹膜透析患者液体摄入健康信念及容量状况,明确糖尿病腹膜透析患者液体摄入健康信念与容量状况的相关性。方法选取2014年1月—2015年1月于宁夏医科大学总医院腹膜透析中心接受腹膜透析治疗的患者156例为研究对象。根据患者是否伴有糖尿病,将患者分为糖尿病组(36例)和无糖尿病组(120例)。由经过统一培训的调查人员采用健康信念量表进行调查,各分量表所有条目的评分累计即为该分量表总分。由专职护士测量并记录患者体质量、舒张压,评估患者水肿严重程度。采用生物电阻抗仪测量患者体内水负荷(OH)、细胞外液(ECW)、细胞内液(ICW)以及细胞外液与细胞内液比值(E/I)。记录患者透析剂量、透析液葡萄糖浓度、超滤量、饮水量及尿量,采用生化自动分析检测仪测定血清清蛋白、血尿素氮、血肌酐、血糖、血钠水平。结果两组患者感知维持容量平衡障碍、感知容量平衡易感性和液体摄入自我效能分量表评分比较,差异均无统计学意义(P0.05)。糖尿病组感知容量平衡益处和感知容量失衡严重性分量表评分低于无糖尿病组,差异有统计学意义(P0.05)。两组体质量、舒张压及水肿程度比较,差异均有统计学意义(P0.05)。糖尿病组OH、ECW、ICW水平高于无糖尿病组,E/I低于无糖尿病组,差异均有统计学意义(P0.05)。糖尿病组透析剂量、透析液葡萄糖浓度、饮水量及清蛋白、血糖水平比较,差异均有统计学意义(P0.05)。糖尿病组无水肿与水肿患者感知容量平衡益处、感知容量失衡严重性、感知容量平衡易感性及液体摄入自我效能分量表评分比较,差异均无统计学意义(P0.05)。糖尿病组水肿患者感知维持容量平衡障碍分量表评分高于无水肿患者,差异有统计学意义(P0.05)。结论糖尿病腹膜透析患者水肿严重程度高于无糖尿病腹膜透析患者,可能与糖尿病腹膜透析患者对容量失衡不良后果认识不足,懫取限制水盐摄入的健康行为缺失,对液体摄入量限制依从性较差有关。
[Abstract]:Objective to compare the health beliefs and volumes of liquid intake between diabetic peritoneal dialysis patients and non-diabetic peritoneal dialysis patients, and to determine the correlation between liquid intake health beliefs and volume status of diabetic peritoneal dialysis patients. Methods 156 patients undergoing peritoneal dialysis in the peritoneal dialysis center of Ningxia Medical University General Hospital from January 2014 to January 2015 were selected as subjects. The patients were divided into diabetic group (n = 36) and non-diabetic group (n = 120). The total score of all items of each subscale was the total score of this subscale. The body mass, diastolic pressure and edema severity of the patients were measured and recorded by full-time nurses. The (ICW) of (ECW), extracellular fluid and the ratio of extracellular fluid to intracellular fluid (E _ (I) were measured by bioelectrical impedance analyzer (BIS) in patients with water load (OH), extracellular fluid (ECW),). The dialysis dose, glucose concentration in dialysate, ultrafiltration volume, drinking quantity and urine volume were recorded. The levels of serum albumin, blood urea nitrogen, serum creatinine, blood glucose and serum sodium were measured by biochemical automatic analysis instrument. Results there was no significant difference between the two groups in the scores of perceived maintenance capacity balance, susceptibility to sensory volume balance and liquid intake self-efficacy scale (P0.05). The score of perceived capacity balance benefit and perceived capacity imbalance severity in diabetic group was lower than that in non-diabetic group (P0.05). There were significant differences in body mass, diastolic pressure and edema between the two groups (P0.05). The level of OH,ECW,ICW in diabetic group was higher than that in non-diabetic group, and the E I level was lower in diabetic group than that in non-diabetic group, the difference was statistically significant (P0.05). There were significant differences in dialysis dose, glucose concentration in dialysate, drinking water, albumin and blood sugar level in diabetic group (P0.05). There was no significant difference in perceived volume balance benefits, perceived capacity imbalance severity, susceptibility to sensory volume balance and liquid intake self-efficacy subscale scores in diabetic patients without edema and edema (P0.05). The score of sensory maintenance capacity balance disorder in diabetic group was higher than that in non-edema group, the difference was statistically significant (P0.05). Conclusion the degree of edema in diabetic peritoneal dialysis patients is higher than that in non-diabetic peritoneal dialysis patients. There may be a lack of understanding of the adverse consequences of volume imbalance in diabetic peritoneal dialysis patients, and the lack of healthy behavior of restricting water and salt intake. Poor compliance with liquid intake limits is associated with poor compliance.
【作者单位】：宁夏医科大学总医院肾脏内科;
【基金】：宁夏自然科学基金资助项目(NZ14153)
【分类号】：R587.1;R459.5

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