钠综合管理对维持性血液透析口渴患者干预效果的研究

    A Study on the effects of comprehensive sodium management on patients with thirst in maintenance hemodialysis

    • 摘要: 目的 分析钠综合管理对维持性血液透析口渴患者的口渴相关指标(口渴、口腔干燥、静息状态唾液量)、容量负荷(血压、透析间期体质量增加值、增长率)的影响。方法 选取2017年9月至2018年5月在连云港市第一人民医院血液净化中心的MHD合并口渴患者85例,采用随机数字表法分为试验组(42例)和对照组(43例),对照组接受常规低盐饮食宣教和标准化钠透析治疗,试验组接受钠综合管理,内容包括基于行为分阶段理论模式的低盐饮食干预,同时根据患者血浆钠离子水平开展个体化钠透析治疗,干预12周后,比较分析两组干预前后的口渴、口腔干燥、静息唾液量、血压、透析间期体质量增加值、增长率。结果 通过钠综合管理12周后试验组和对照组口渴、口腔干燥、静息状态唾液量、收缩压、舒张压、透析间期体质量增加值、增长率均有统计学意义(P<0.05)。结论 钠综合管理可以减轻患者的口渴,改善患者血压,减少透析间期体质量增加,减轻患者的容量负荷。

       

      Abstract: Objective To analyze the effects of comprehensive sodium management on thirst-related indicators(thirst, xerostomia, unstimulated whole saliva), volumetric load (blood pressure, interdialytic weight gain and growth rate) in maintenance hemodialysis. Methods A total of 85 MHD patients with thirst in the Blood Purification Center of Lianyungang First People's Hospital from September 2017 to May 2018 were selected and randomly divided into the experimental group (42 cases) and the control group (43 cases). The control group received routine low-salt diet education and standardized sodium dialysis treatment. The experimental group received comprehensive sodium management including low-salt diet intervention based on the behavioral phased theoretical model, and performed individualized sodium dialysis treatment according to the patient's plasma sodium level. After 12 weeks of intervention, the two groups were compared before and after intervention, with respect to thirst, xerostomia, unstimulated whole saliva, blood pressure, and interdialytic weight gain and growth rate. Results After 12 weeks of comprehensive management of sodium, thirst, xerostomia, unstimulated whole saliva, systolic blood pressure, diastolic blood pressure, and interdialytic weight gain and growth rate exhibited statistically significant differences in both the experimental group and the control group, compared to those before intervention (P<0.05). Conclusions In patients with MDH, comprehensive sodium management can reduce thirst, improve blood pressure, reduce weight gain during dialysis interval, and reduce volumetric load.

       

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