腹膜透析患者自我管理行为与营养状况及容量负荷的相关性研究

Research on correlation between self-management behaviors of peritoneal dialysis patients and nutrition condition and capacity load

目的:探讨腹膜透析患者自我管理行为与营养状况及容量负荷的关系。方法:2014年1月~2016年12月选取腹膜透析时间大于3个月的患者150例为研究对象,根据患者容量负荷情况将患者分为无水肿组(n=75),轻度水肿组(n=40),中度水肿组(n=20)及重度水肿组(n=15),应用自我管理行为评定量表评定各组自我管理行为,并测定各组患者营养状况。结果:腹膜透析无水肿组患者血清蛋白、血红蛋白水平高于其余各组(P<0.05),而24 h腹膜液蛋白丢失量少于其余各组(P<0.05),且随着腹膜透析患者容量负荷量增加(P<0.05),患者血清蛋白、血红蛋白水平明显减少(P<0.05),而24 h腹膜液蛋白丢失量明显增加(P<0.05)。腹膜透析无水肿组在饮食及液体摄入、治疗行为、身体活动、心理社会行为及自我管理行为总分方面均高于轻度、中度及重度水肿组(P<0.05),且随着腹膜透析患者容量负荷量增加患者自我管理行为总评分及各维度评分明显下降(P<0.05)。经Pearson单因素分析可知,腹膜透析患者自我管理行为与患者容量负荷量及24 h腹膜液蛋白丢失量呈负相关(P<0.05),而与血清蛋白、血红蛋白水平呈正相关(P<0.05)。结论:容量负荷量增多的腹膜透析患者营养状况恶化,而患者自我管理行为与营养状况及腹膜透析负荷量有密切的关系,通过提高患者自我管理行为将有助于改善患者容量负荷量及营养状况。

Objective To discuss the relation between the self - management behaviors of peritoneal dialysis patients and their nutrition condition and capaci-ty load. Methods ： Selected 150 patients with peritoneal dialysis duration more than 3 months from January 2014 to December 2016 as the research object, and the patients were divided into no edema group （ n =15） , slight edema group （ n, = 40） , moderate edema group （ n, = 20） and severe edema group （n = 15）,and self - management behavior rating scale was used to evaluate the self - management behaviors of each group and determine the nutrition condition of patients in each group. Results ： The serum protein, hemoglobin levels of peritoneal dialysis patients in the no edema group were higher than those of pa-tients in other groups（P 〈0.05） , while their loss of peritoneal fluid protein within 24h was less than that of patients in other groups（P 〈0. 05） , and with the increase of capacity load of peritoneal dialysis patients（P 〈0.05 ） ,the patients5 serum protein and hemoglobin levels decreased significantly（P 〈0.05）, while the peritoneal fluid protein within 24h increased（P 〈0.05）. The peritoneal dialysis patients in the no edema group hand total scores of diet and fluid di-gestion ,treatment behavior, physical activity, psychological and social behaviors and self - management behavior than those of patients in the slight, mod-erate and severe edema groups（P 〈0. 05） , and with the increase of capacity load of peritoneal dialysis patients, the total scores and score of each dimen-sion of self - management behavior of patients decreased significantly （P 〈 0. 05 ）. Through Pearson single - factor analysis, the self - management behavior of peritoneal dialysis patients was of negative correlation with the patients5 capacity load amount and loss of peritoneal fluid protein within 24h （P 〈 0.05）, while it was of positive correlation with the serum protein and hemoglobin levels（P 〈0. 05）. Conclusion： The peritoneal dialysis patients with increase of load capacity had their nutrition condition aggravated, while the patients5 self - management behavior had a close relation with nutrition condition and peri-toneal dialysis load capacity, and by improving the patients5 self - management behavior, it would be helpful to improve the patients5 capacity load and nu-trition condition.