血液透析患者血钙浓度的调查分析和护理

Investigation and Nursing of Blood Calcium Concentration in Hemodialysis Patients

目的回顾性分析单中心维持性血液透析患者钙浓度,调查低钙血症、高钙血症的患病率、诊疗和护理措施。方法本研究为单中心回顾性研究。分析福建医科大学附属漳州市医院血透室2019年5月血液透析266例患者钙浓度检查的结果。并分析其诊疗和护理措施。同时调查患者自行购买钙制剂的比例。结果本研究纳入266例的患者资料。患者血液透析前的平均血钙水平为2.08 mmol/L(1.51~2.87 mmol/L),其中146例患者低钙血症,1例患者高钙血症。上述患者均无明显低钙或高钙的相关症状。89例口服钙制剂治疗,25例维生素D制剂治疗,10例口服西那卡塞治疗,19例口服开同治疗。3例患者自行购买钙制剂。护理措施包括:饮食宣教、用药指导等。结论血液透析患者合并钙代谢紊乱的发生率高,二者均可无症状。严格的掌握钙制剂、维生素D制剂和开同应用,并加强护理宣教可以有效控制高钙血症。

Objective To retrospectively analyze the prevalence,diagnosis and therapy of calcium metabolism disorders in patients undergoing maintenance hemodialysis in a single center.Methods This study is a single-center retrospective study.To analyze the results of calcium concentration examination of 266 patients on hemodialysis in the hemodialysis room of Zhangzhou Hospital Affiliated to Fujian Medical University in May 2019.And analyze its diagnosis and treatment measures.At the same time,investigate the proportion of patients who purchase calcium preparations by themselves.Result This study included data from 266 patients.The patient's average blood calcium level before hemodialysis was 2.08 mmol/L(1.51-2.87 mmol/L),of which 146 patients had hypocalcemia and one patient had hypercalcemia.None of the above patients had obvious symptoms related to low or high calcium.Eightynine cases were treated with calcium preparations,25 cases were treated with vitamin D preparations,10 cases of oral calcimimetics treatment,19 cases of oral compound alpha-keto acid tablets treatment.Three patients purchased calcium preparations by themselves.Nursing measures include:dietary education,medication guidance,etc.Conclusion Hemodialysis patients had a high prevalence of calcium metabolism disorders,both can be asymptomatic.Strict control of calcium preparation,vitamin D preparation and application of nursing interventions contribute to control hypercalcemia.