腹膜透析护理团队对透析液中葡萄糖吸收量的估算方法探讨

Discussion on the evaluation method of estimating glucose absorption in peritoneal dialysis

目的评估经腹膜透析液吸收葡萄糖量(GA)的几种估算方法与实测值之间的差异,为腹膜透析护理团队寻找方便、准确的估算方法。方法选择2019年1—6月在首都医科大学附属北京安贞医院肾内科腹膜透析门诊定期复查行连续性不卧床腹膜透析(CAPD)患者44例,腹膜透析护理团队将常用的几种经腹膜透析液GA的估算公式获得的值与实测值进行比较,判定是否存在统计学差异。结果应用Grodstein公式、Bodnar公式、K/DOQI公式、经验法一(按60%葡萄糖吸收率估算)及经验法二(白天按50%,夜间按80%葡萄糖吸收率估算)获得的GA值分别为81.3(64.2,118.0)、(97.8±19.7)、(94.1±25.8)、87.1(76.2,109.0)、(89.5±16.0)g;实测值为94.2(77.5,111.6)g。经配对样本的Wilcoxon符号秩检验分析,仅Bodnar公式及K/K/DOQI公式的估算值与实测值间差异无统计学意义。结论腹膜透析患者可以考虑应用Bodnar公式及K/DOQI公式对吸收的葡萄糖量进行粗略估算,但要精确值时仍需进行实测。

Objective To evaluate the reliability of several formulae for estimating the quantity of glucose absorption of peritoneal dialysate(GA).Methods Forty-four patients receiving continuous ambulatory peritoneal dialysis(CAPD)were enrolled in this study.The quantities of GA obtained from actual measurement and estimation were compared to judge whether there was statistical difference between them.Results The GA quantities estimated by Grodstein formula,Bodnar formula,K/DOQI formula,empirical method A(based on 60%absorption rate)and empirical method B(based on 50%absorption rate in daytime and 80%absorption rate in night)were as follows:81.3(64.2,118.0)g,(97.8±19.7)g,(94.1±25.8)g,87.1(76.2,109.0)g and(89.5±16.0)g,respectively;the actually measured GA quantity was[94.2(77.5,111.6)]g.Wilcoxon signed rank test of paired samples showed that only the results of Bodnar formula and K/DOQI formula did not present statistical differences from actually measured result.Conclusion It can be considered to use Bodnar formula and K/DOQI formula to roughly estimate the GA quantity of CAPD patients,but to accurately understand the individual GA value,actual measurement is still required.