| 汪海燕,席惠君,王铁云,赵丽芳,杜俊,李双喜,赖学莉,郭志勇.腹膜透析患者低钾血症发生率及其相关因素分析[J].上海护理,2018,18(11): |
| 腹膜透析患者低钾血症发生率及其相关因素分析 |
| The incidence and correlation factors of hypokalemia in patients receiving peritoneal dialysis |
| DOI： |
| 中文关键词: 腹膜透析 低钾血症 饮食 相关因素 |
| 英文关键词:Peritoneal Dialysis Hypokalemia Diet Correlation factors |
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| 中文摘要: |
| 目的 调查研究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式提供理论依据。 方法 选取2017年2月～2017年7月至长海医院腹膜透析中心规律随访的90例腹膜透析患者，利用两轮三日饮食日记法记录患者饮食情况，在第二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＜3.5mmol/L)、非低钾组（血钾≥3.5mmol/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、饮食热卡摄入比、血前白蛋白、丢钾总量以及性别之间有统计学差异（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。饮食热卡摄入比、血白蛋白、血红蛋白、腹膜转运特性等不是低钾血症的直接相关因素。 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）是腹透患者低钾血症的直接相关因素，所以护士在患者随访管理时在饮食宣教和管理中应强化该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，其次应该尤其跟踪女性腹透患者自我管理的依从性。 |
| 英文摘要: |
| Abstract: Objective To find out the major correlation factors responsible for hypokalemia so as to provide a theoretical basis for establishing targeted intervention means. Methods 90 patients receiving peritoneal dialysis who paid follow-up visits regularly to Changhai hospital dialysis center from February 2017 to July 2017 were included. Of the 90 patients, there were 44 males and 46 females from 27 to 86 years old. The patient’s diets were recorded for two rounds using the three-day diet diary method. The following specimens and indexes were collected from the patients at the week after recording the second round of diet diary: blood potassium, blood albumin, hemoglobin, blood prealbumin, peritoneal transport characteristics, ultrafiltration volume of peritoneal dialysis, urine volume, etc. These patients were assigned to the hypokalemia group (the blood potassium level < 3.5mmol/L) and the non-hypokalemia group (the blood potassium level ≥ 3.5mmol/L). Results The incidence of hypokalemia in patients receiving peritoneal dialysis was 25.56%. There was statistical difference between the hypokalemia group and the non-hypokalemia group in terms of diet potassium intake, diet protein intake ratio, diet calorie intake ratio, prealbumin, total potassium loss and gender（P＜0.05）. Logistic stepwise regression analysis showed that, the direct correlation factors for hypokalemia in patients receiving peritoneal dialysis were diet potassium intake, diet protein intake ratio , prealbumin and gender. And diet calorie ratio, blood albumin, hemoglobin, peritoneal transport characteristics and so on were not direct correlation factors for hypokalemia. Conclusion Hypokalemia is relatively common in patients receiving peritoneal dialysis. As diet (diet potassium intake, diet protein intake ratio )is a direct correlation factor for hypokalemia in patients receiving peritoneal dialysis, when managing patients’ follow-ups, nurses should reinforce instructions and follow-ups on diet for patients during diet education and management. Meanwhile, when monitoring data during follow-ups, we should above all focus on patients’ prealbumin changes and secondly we should especially follow up the self-management compliance in female patients receiving peritoneal dialysis. |
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