中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (12): 865-868.doi: 10.3969/j.issn.1671-4091.2019.12.016

• 护理研究 • 上一篇    下一篇

持续非卧床腹膜透析慢性心功能不全患者再入院影响因素分析

许义1,孟丹2,杨静1,张利宣1,汪小华3,李琳1,卢国元1   

  1. 苏州大学附属第一医院1肾内科26 区 2移植血液净化中心  3苏州大学护理学院
  • 收稿日期:2019-04-15 修回日期:2019-08-01 出版日期:2019-12-12 发布日期:2019-12-03
  • 通讯作者: 孟丹xucy8327@126.com E-mail:1790956442@qq.com

Factors affecting the re- hospitalization due to chronic cardiac insufficiency in patients on continuous ambulatory peritoneal dialysis#br#

  1.  1Department of Nephrology and 2Center for Transplantation and Blood Purification, First Affiliated Hospital of Suzhou University, Suzhou 215006, China; 3College of Nursing, Suzhou University, Suzhou 215006, China
  • Received:2019-04-15 Revised:2019-08-01 Online:2019-12-12 Published:2019-12-03

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摘要： 【摘要】目的探讨持续非卧床腹膜透析(continuous ambulatory peritoneal dialysis，CAPD)慢性心功能不全患者6 个月内再入院的危险因素。方法回顾性分析2017 年1 月～2018 年12 月在苏州大学附属第一医院肾内科腹膜透析中心的CAPD 患者204 例。采用Log-rank 单因素分析和多因素Cox 回归分析法，探讨CAPD 慢性心功能不全患者再入院原因。结果6 个月内再入院人数为59 例，占总人数的28.92%。2 组患者在尿素氮、血清前白蛋白、收缩压、舒张压、容量管理水平和水肿程度方面存在统计学差异(c2 值分别为3.765，6.021，4.652，3.623，6.211，6.041；P 值分别为0.017，0.001，0.015，0.018，0.001，0.001)。多因素COX 回归分析示，容量管理水平、血清前白蛋白和水肿程度是CAPD 慢性心功能不全患者6 个月内再入院的危险因素(95%CI 值分别为1.298～2.432，1.421～2.765，1.021～2.002；OR 值分别为2.003，2.112，1.675；P 值分别为0.023，0.001，0.034)。结论腹膜透析护士应提高CAPD 患者的容量管理水平、改善营养状态和水肿程度，进而降低再住院率。

关键词: 持续非卧床腹膜透析, 慢性心功能不全, 再住院, 影响因素

Abstract:

【Abstract】Objective To explore the risk factors for the re- hospitalization within six months due to chronic cardiac insufficiency in patients on continuous ambulatory peritoneal dialysis (CAPD). Methods We retrospectively analyzed 204 CAPD patients who were diagnosed chronic cardiac insufficiency from January 2017 to December 2018. Log-rank test for univariate analysis and Cox regression model for multivariate analysis were used to explore the cause of re-hospitalization due to chronic cardiac insufficiency in these CAPD patients. Results Re- hospitalization within six months happened in 59 cases with the recurrence rate of 28.92%. There are statistically differences in blood urea nitrogen (c2=3.765, P=0.017), serum pre- albumin (c2=6.021, P=0.001), systolic blood pressure (c2=4.652, P=0.015), diastolic blood pressure (c2=3.623, P=0.018), volume management (c2=6.211, P=0.001), edema degree (c2=6.041, P=0.001) between the two groups. Multivariate Cox regression analyses showed that volume management (95% CI 1.298～2.432, OR=2.003, P= 0.023), serum pre-albumin (95% CI 1.421～2.765, OR=2.112, P=0.001) and edema degree (95% CI1.021～2.002, OR=1.675, P=0.034) were the risk factors for re- admission within six months in CAPD patients. Conclusion Nurses working for CAPD patients should increase their abilities in volume management, improvement of nutritional status and edema classification to reduce the re-admission rate.

Key words: Continuous ambulatory peritoneal dialysis, Chronic cardiac insufficiency, Re- hospitalization, Risk factor

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