实施自我管理教育对糖尿病肾病行腹膜透析病人的影响  

Study on the effect of peritoneal dialysis for patient with diabetes nephropathy through carrying out self management education

作　　者：马艳秋[1] 苏春燕[1] 张枫[1] 聂建东[1] 汪涛[1] 

机构地区：[1]北京大学第三医院肾内科,北京100083

出　　处：《护士进修杂志》2007年第8期678-680,共3页Journal of Nurses Training

基　　金：中华人民共和国教育部长江学者奖励计划;教育振兴行动计划专项基金(985工程-36-1);北京大学"211工程"循证医学学科群科研项目(38-18)

摘　　要：目的对31例糖尿病肾病腹膜透析病人进行自我管理教育,旨在提高病人自我管理能力,从而改善血糖及容量状况。方法对31例接受规律腹膜透析>3个月的糖尿病肾病患者进行6个月的自我管理教育及密切的追踪随访,于干预前后分别评估患者血糖控制、容量控制状况。结果经过6个月的自我管理教育,患者自我管理能力明显提高,糖化血红蛋白由6.68%下降至6.35%,总排钠由3.48 g/d下降至2.58 g/d,平均血清钠离子浓度由137.64 mmol/L下降至136.14 mmol/L,体重由61.67 kg下降至59.89 kg,E/I由1.25下降至1.15。经配对t检验,差异有统计学意义(P<0.05)。同时,病人的总液体清除量没有增加,血压控制率由35.5%上升到51.6%(χ2值10.542,P<0.01)。结论自我管理教育,可以提高糖尿病肾病腹膜透析病人的依从性及病人的自我管理能力。Objective To evaluate the effects of self-management education on peritoneal dialysis patients with diabetic nephropathy. Method 31 peritoneal dialysis patients with diabetic nephropathy were enrolled in this study. Self-management education was applied by various ways. All the enrolled patient were followed up closely through clinic or telephone after discharged. Result The patients＇ HbAIC level were decreased from 6.68% to 6.35%. Total sodium clearance （from 3.48 g/d to 2.58 g/d）, serum sodium ion concentration （from 137.64mmol/L to 136.14 mmol/L）, body weight （from 61.6 kg to 59.8 kg） and E/I（from 1.25 to 1.15） were dropped after self management education. There are significant difference（P〈0.05）, at the same time, controlled hypertension rate increased from 35.5 % to 51.6% （P〈0.01）, while total fluid removal didn＇t increased. Conclusion Self-management education can improve the patients＇ adherence to treatment regimen and disease management, facilitate the blood glucose level and volume overload control.

关 键 词：腹膜透析 糖尿病肾病 自我管理教育 

分 类 号：R472[医药卫生—护理学] R692[医药卫生—临床医学]