血液透析患者行量化管理对血清钙、磷、PTH水平和透析充分性的影响

Effects of Quantitative Management on Serum Calcium,Phosphorus,PTH and Dialysis Adequacy in Hemodialysis Patients

目的对血液透析患者行量化管理,观察其血清钙(Ca)、磷(P)、甲状旁腺素(PTH)水平和透析充分性变化。方法将我院102例血液透析患者随机分为对照组(n=51)和观察组(n=51),对照组给予常规护理,观察组在前者基础上给予量化管理,比较两组血清Ca、P、PTH水平及达标率,残余肾功能(RRF),24 h尿量,透析充分性[尿素清除分数(Kt/V)、尿素下降率(URR)]。结果护理后,两组血清Ca水平均升高(P<0.05),P及PTH水平均降低(P<0.05),且观察组变化幅度大于对照组(P<0.05);护理后,观察组Ca、P水平达标率升高(P<0.05),但与对照组比较差异均无统计学意义(P>0.05);护理后,两组RRF和24h尿量均降低(P<0.05),且观察组RRF和24h尿量均高于对照组(P<0.05);护理后,观察组Kt/V和URR水平均高于对照组(P<0.05);护理后,观察组Kt/V、URR达标率升高(P<0.05),但与对照组比较差异无统计学意义(P>0.05);观察组护理后CKD-MBD发生率低于对照组(P<0.05)。结论血液透析患者行量化管理可以有效调节血清Ca、P、PTH水平,提高透析充分性。

Objective To examine the levels of serum calcium(Ca),phosphorus(P)and parathyroid hormone(PTH)and dialysis adequacy changes with quantitative management in hemodialysis patients.Methods 102 hemodialysis patients in our hospital were randomly divided into the control group(n=51)and the observation group(n=51).The control group was given routine nursing,while the observation group was given quantitative management on the basis of treatments of the control group.The levels and control rates of serum Ca,P and PTH,residual renal function(RRF),24h urine volume,dialysis adequacy[fractional clearance of urea(Kt/V),urea reduction ratio(URR)]were compared between the two groups.Results After nursing,the serum Ca levels of the two groups were increased(P<0.05),while the levels of P and PTH were decreased(P<0.05),and the changes in the observation group were greater than those in the control group(P<0.05).After nursing,the control rates of Ca and P in the observation group were increased(P<0.05),but were not significantly different from those in the control group(P>0.05).After nursing,the RRF and 24h urine volume in the two groups were decreased(P<0.05),and the RRF and 24h urine volume in the observation group were higher than those in the control group(P<0.05).After nursing,the levels of Kt/V and URR in the observation group were higher than those in the control group(P<0.05).After nursing,the compliance rates of Kt/V and URR in the observation group were increased(P<0.05),but there were no significant differences compared with those of the control group(P>0.05).The incidence rate of CKD-MBD in the observation group was lower than that in the control group(P<0.05).Conclusion Quantitative management for hemodialysis patients can effectively regulate the levels of serum Ca,P and PTH,and improve the dialysis adequacy.