老年慢性心力衰竭患者低钠血症的相关因素分析及护理  

Analysis of related factors and nursing methods for hyponatremia in the elderly patients with chronic heart failure

作　　者：刘志英[1] 何婷婷[2] 侯惠如[1] 

机构地区：[1]解放军总医院南楼护理部,北京100053 [2]解放军总医院南楼心血管二科,北京100053

出　　处：《中华现代护理杂志》2013年第10期1148-1150,共3页Chinese Journal of Modern Nursing

基　　金：全军医学科技“十二五”科研项目（11BJZ18）

摘　　要：目的探讨老年慢性心衰患者发生低钠血症的相关因素，为临床防治低钠血症及护理提供依据。方法选择解放军总医院老年心内科住院的65岁以上慢性心力衰竭患者143例，其中低钠组47例，非低钠组96例；低钠组中年龄≥80岁高龄患者29例，年龄65～79岁老年患者19例；比较各组患者临床资料及特点。结果低钠组年龄（88.5±4.8）岁，非低钠组年龄（82.5±7.5）岁，差异有统计学意义（t＝4.895,P＜0.01）；低钠组患者高血压、肺部感染、糖尿病患病率、急性左心衰发生率及利尿剂、鼻饲使用率均高于非低钠组，两组比较，差异有统计学意义（χ2值分别为26.034,14.492,5.385,10.881,12.674,5.389;P＜0.05）。高龄老年组补钠至正常值所需时间（11.7±3.0）d，老年组补纳至正常值所需时间为（7.6±2.1）d，差异有统计学意义（t＝5.069,P＜0.01）。结论老年慢性心衰患者发生低钠血症易诱发急性左心衰；高龄慢性心衰患者发生低钠血症时症状常不典型，容易被忽视，提示护理人员在护理时注意观察，及时监测血钠，以免延误病情。Objective To study the related factors of hyponatremia in the elderly patients with chronic heart failure in order to provide evidences for preventing and nursing of hyponatremia. Methods Clinical data of 143 patients over 65 years old were investigated. The patients were divided into hyponatremia group（ n = 47） and control group （n =96）. There were 29 cases with more than 80 years older and 19 cases with 65 -79 years older in hyponatremia group. The data from the two groups were compared. Results The patients in hyponatremia group were significantly older than these in control group [ （ 88.5 ± 4.8 ） vs （ 82.5 ± 7.5 ） , t = 4. 895 ,P 〈 0.01 ） , and the incidences of hypertension, pneumonia, diabetes and acute heart failure, as well as the usage of diuretics and nasogastric tubes in hyponatremia group were significantly higher than that in the control group （ χ^2 = 26. 034,14. 492,5. 385,10. 881,12. 674,5. 389 ; P 〈 0.05 ）. Very elderly patients needed longer time to achieve normal natrium level in blood serum than that elderly patients （ t = 5. 069, P 〈 0.01 ）. Conclusions Hyponatremia of the elderly patients with chronic heart failure was related to hypertension, pneumonia, diabetes, acute heart failure, usage of diuretics and nasogastrie tubes. The symptoms of hyponatremia in very elderly patients is atypical, which are very likely to be neglected. We should pay more attention to the special population.

关 键 词：老年人 低钠血症 慢性心力衰竭 

分 类 号：R473.5[医药卫生—护理学]