摘要
目的调查导致腹膜透析患者发生低钾血症的主要相关因素,为建立针对性的干预方案提供理论依据。方法选取2017年2—7月至海军军医大学附属长海医院腹膜透析中心规律随访的腹膜透析患者90例,利用两轮三日饮食日记法记录患者饮食情况,在第2轮饮食日记记录后次周采集标本,包括患者血钾、血白蛋白、血红蛋白、血前白蛋白、腹膜转运特性、腹透超滤量和尿量等指标。根据血钾水平分为低钾组(血钾<3. 5 mmol/L)、非低钾组(血钾≥3. 5 mmol/L)。结果腹膜透析患者低钾血症的发生率为25. 6%。低钾血症组和非低钾血症组在饮食摄钾量、饮食蛋白质摄入比、饮食热量摄入比、血前白蛋白、丢钾总量以及性别方面差异有统计学意义(P <0. 05),Logistic逐步回归法分析得出腹透患者低钾血症的直接相关因素为饮食摄钾量、饮食蛋白质摄入比、血前白蛋白及性别。结论低钾血症在腹膜透析患者中较常见,饮食(饮食摄钾量、饮食蛋白质摄入比)是腹膜透析患者低钾血症的直接相关因素。护士在对腹膜透析患者进行饮食宣教和随访管理中,应强化此项内容的指导和随访,同时在随访监测数据中应重点关注患者血前白蛋白的变化,其次是跟踪患者尤其是女性患者自我管理的依从性。
Objective To investigate the major factors responsible for hypokalemia in the patients receiving peritoneal dialysis, so as to provide a theoretical basis tor establishing targeted intervention means. Methods A total of 90 patients receiving peritoneal dialysis who were tollowed up regularly in Changhai Hospital Dialysis Center from February to July 2017 were included. Of the 90 patients, there were 44 males and 46 temales, aged at 27 to 86 years. The patients＇ diets were recorded tor two rounds using the three-day diet diary method. The tollowing specimens and indices were collected from the patients： blood potassium, blood albumin, hemoglobin, blood prealbumin, peritoneal transport characteristics, ultrafiltration volume of peritoneal di volume, etc. These patients were assigned to the hypokalemia group （blood potassium level 〈 3 aly .5 SIS, urine and the non-hypokalemia group （blood potassium level ≥ 3. 5 mmol/L ）. Results The incidence of hypokalemia in the patients receiving peritoneal dialysis was 25.6%. There were statistical differences between hypokalemia group and non-hypokalemia group in dietaiT potassium intake, diet protein intake ratio, dietaiT calorie intake ratio, prealbumin, total potassium loss and gender （ P 〈 0.05 ）. Logistic stepwise regressionanalysis showed that the direct influencing factors of hypokalemia in the patients receiving peritoneal dialysis were dietary potassium intake, dietary protein intake ratio, prealbumin and gender. Conclusion Hypokalemia isrelatively common in the patients receiving peritoneal dialysis. As diet （diet potassium intake, dietary protein intake ratio is a direct correlation factor of hypokalemia, the nurses should reinforce the dietary instructions and tollow-ups. Meanwhile, the patients＇ prealbumin changes and self-management compliance in female patients should be strengthened
作者
汪海燕
席惠君
王铁云
赵丽芳
杜俊
李双喜
赖学莉
郭志勇
WANG Haiyan;XI Huijun;WANG Tieyun;ZHAO Lifang;DU Jun;LI Shuangxi;LAI Xueli;GUO Zhiyong(Changhai Hospital,Naval Military Medical University,Shanghai 200433,China)
出处
《上海护理》
2018年第11期32-35,共4页
Shanghai Nursing
关键词
腹膜透析
低钾血症
饮食
影响因素
Peritoneal dialysis
Hypokalemia
Diet
Influencing factor
