摘要
目的探究维持性血液透析患者残余肾功能下降危险因素,为制定护理对策提供参考依据。方法选取2018年2月—2019年10月在医院进行维持性血液透析治疗的159例患者为研究对象,根据3个月内患者血液透析期间尿素氮清除速率,将患者分为高残余肾功组、低残余肾功组及无残余肾功组,对比3组患者基础资料、合并疾病情况、实验室及心功能检查结果,并采用Logistic回归分析法,探究其危险因素。结果患者中以高残余肾功组人数最多,占全部患者的58.49%,高于低残余肾功组及无残余肾功组,无残余肾功组患者占全部患者的12.58%。单因素分析显示,年龄、BMI、合并高血压、血清白蛋白、合并糖尿病、血β2微球蛋白(β2-MG)指标比较差异有统计学意义(P<0.05)。多因素回归分析结果显示,合并高血压、血清白蛋白、合并糖尿病、β2-MG为维持性血液透析患者残余肾功能下降的影响因素(P<0.05)。结论维持性血液透析患者残余肾功能下降是多因素综合作用的结果,应通过加强患者透析治疗前评估工作,保证患者透析期间心态平稳及适当扩容等方式,降低患者透析期间残余肾功能降低速度。
Objective To explore the risk factors and nursing countermeasures of residual renal function decline in maintenance hemodialysis patients,and to provide reference basis for fromulating nursing countermeasures.Methods To select 159 patients who underwent maintenance hemodialysis in the hospital from February 2018 to October 2019 as the study objects.According to the urea nitrogen clearance rate during hemodialysis within 3 months,the patients were divided into a high residual renal function group,a low-residual renal function group and a non-residual renal function group to compare the basic data,comorbid disease,laboratory and cardiac function test results of the three groups of patients,and Logistic regression analysis was used to explore their risk factors.Results Among the patients,the high residual renal function group accounted for the largest number of patients,accounting for 58.49% of all patients,which was higher than the low residual renal function group and the non-residual renal function group.Patients in the non-residual renal function group accounted for 12.58% of all patients.Univariate analysis showed that there were statistically signifi cant diff erences in age,BMI,combined with hypertension,serum albumin,combined with diabetes mellitus,and blood β2 microglobulin(β2-MG)index(P<0.05).Multivariate Logistic regression analysis showed that the,combined with hypertension,serum albumin,combined with diabetes mellitus,and β2-MG were the infl uencing factors for the decline of residual renal function in maintenance hemodialysis patients(P<0.05).Conclusion The decline of residual renal function in maintenance hemodialysis patients was the result of a comprehensive eff ect of multiple factors.It was necessary to strengthen the evaluation of patients before dialysis to ensure a stable mental state and appropriate expansion during dialysis to reduce the rate of decrease in residual renal function during dialysis.
作者
张三利
ZHANG Sanli(Shanghai Changzheng Hospital,Shanghai,200003,China)
出处
《护理实践与研究》
2021年第22期3347-3350,共4页
Nursing Practice and Research
关键词
维持性血液透析
残余肾功能
危险因素
护理对策
Maintenance hemodialysis
Residual renal function
Risk factors
Nursing countermeasures
