利尿剂使用情况、低盐饮食、术中血液稀释与心脏瓣膜置换术后并发低钠血症关联性及护理措施分析

Analysis of the Relationship between Diuretic Use,Low-salt diet,Intraoperative Blood Dilution,and Hyponatremia after Cardiac Valve Replacement and Nursing Measures

目的探讨利尿剂使用情况、低盐饮食、术中血液稀释与心脏瓣膜置换术后并发低钠血症的关联性及护理措施。方法选取我院60例行心脏瓣膜置换术患者(2018年6月至2019年6月),均以离子选择电极法检测血清钠水平,并按照检测结果分为研究组(低钠血症)、对照组(非低钠血症)。比较两组一般资料,分析低钠血症发生的相关影响因素。结果60例我院行心脏瓣膜置换术患者23例发生低钠血症(研究组),发生率38.33%;37例未发生低钠血症(对照组);研究组术中血液稀释程度、低钠饮食率高于对照组,利尿剂使用量大于对照组(P<0.05);Logistic回归分析显示,术中血液稀释、低钠饮食及利尿剂使用情况是心脏瓣膜置换术后并发低钠血症的影响因素(P<0.05)。结论利尿剂使用情况、低盐饮食、术中血液稀释与心脏瓣膜置换术后并发低钠血症具有一定关联性,故临床可据此实施针对性干预措施,以降低低钠血症发生风险。

Objective To investigate the relationship between diuretic use,low-salt diet,intraoperative blood dilution,and hyponatremia after cardiac valve replacement and nursing measures.Methods A total of 60 patients undergoing heart valve replacement in our hospital(from June 2018 to June 2019)were selected to detect serum sodium levels by ion selective electrode method,and were divided into study groups(hyponatremia)and control group(non-hypernatremia).The general data of the two groups were compared,and the related influencing factors of hyponatremia were analyzed.Results Of the 60 patients undergoing heart valve replacement,23 cases had hyponatremia(study group),with an incidence of 38.33%;37 cases didn’t have hyponatremia(control group);The degree of blood dilution and low-sodium diet in the study group were higher than those in the control group,and the amount of diuretics was greater than that in the control group(P<0.05).Logistic regression analysis showed that the blood dilution,low-sodium diet,and diuretic use during the operation were the heart Influential factors of hyponatremia after valve replacement(P<0.05).Conclusion The use of diuretics,low-salt diet,intraoperative blood dilution,and hyponatremia after cardiac valve replacement are related to some extent,so targeted interventions can be implemented accordingly to reduce the risk of hyponatremia.