發(fā)布時間：2019-04-10 16:41

【摘要】：目的通過比較糖尿病腹膜透析與無糖尿病腹膜透析患者液體攝入健康信念及容量狀況,明確糖尿病腹膜透析患者液體攝入健康信念與容量狀況的相關(guān)性。方法選取2014年1月—2015年1月于寧夏醫(yī)科大學(xué)總醫(yī)院腹膜透析中心接受腹膜透析治療的患者156例為研究對象。根據(jù)患者是否伴有糖尿病,將患者分為糖尿病組(36例)和無糖尿病組(120例)。由經(jīng)過統(tǒng)一培訓(xùn)的調(diào)查人員采用健康信念量表進(jìn)行調(diào)查,各分量表所有條目的評分累計(jì)即為該分量表總分。由專職護(hù)士測量并記錄患者體質(zhì)量、舒張壓,評估患者水腫嚴(yán)重程度。采用生物電阻抗儀測量患者體內(nèi)水負(fù)荷(OH)、細(xì)胞外液(ECW)、細(xì)胞內(nèi)液(ICW)以及細(xì)胞外液與細(xì)胞內(nèi)液比值(E/I)。記錄患者透析劑量、透析液葡萄糖濃度、超濾量、飲水量及尿量,采用生化自動分析檢測儀測定血清清蛋白、血尿素氮、血肌酐、血糖、血鈉水平。結(jié)果兩組患者感知維持容量平衡障礙、感知容量平衡易感性和液體攝入自我效能分量表評分比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。糖尿病組感知容量平衡益處和感知容量失衡嚴(yán)重性分量表評分低于無糖尿病組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組體質(zhì)量、舒張壓及水腫程度比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。糖尿病組OH、ECW、ICW水平高于無糖尿病組,E/I低于無糖尿病組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。糖尿病組透析劑量、透析液葡萄糖濃度、飲水量及清蛋白、血糖水平比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。糖尿病組無水腫與水腫患者感知容量平衡益處、感知容量失衡嚴(yán)重性、感知容量平衡易感性及液體攝入自我效能分量表評分比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。糖尿病組水腫患者感知維持容量平衡障礙分量表評分高于無水腫患者,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論糖尿病腹膜透析患者水腫嚴(yán)重程度高于無糖尿病腹膜透析患者,可能與糖尿病腹膜透析患者對容量失衡不良后果認(rèn)識不足,懫取限制水鹽攝入的健康行為缺失,對液體攝入量限制依從性較差有關(guān)。
[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.
【作者單位】： 寧夏醫(yī)科大學(xué)總醫(yī)院腎臟內(nèi)科;
【基金】：寧夏自然科學(xué)基金資助項(xiàng)目(NZ14153)
【分類號】：R587.1;R459.5

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