健康教育对血液透析患者合并高磷血症的影响

目的：通过健康教育降低血液透析患者高磷血症的发生率。方法整群选取2014年1月-2014年4月厦门大学附属中山医院血透中心符合纳入标准的76例患者为研究对象,进行问卷调查,包括对高含磷食物的知晓程度、日常饮食中磷的摄入以及磷结合剂的使用情况等。分析引起高磷血症的可能原因,并反复对患者及其家属进行个体化宣传教育,给予正确指导。在宣教前及宣教后3个月进行空腹血磷测定,比较宣教前后的血磷水平、磷结合剂的使用量及高磷血症的发生率。结果健康教育前对高含磷食物种类了解的人数为18例,宣教后人数增加至56例；宣教前76例血透患者空腹血磷的平均值为(2.56±0.76﹚mmol/L,引起高磷血症的主要原因包括单纯磷摄入过多、单纯磷结合剂使用不当、未服用磷结合剂及磷摄入过多合并磷结合剂使用不当4种情况,分别占25.0%、42.1%、15.8%、13.2%；通过个体化宣教患者空腹血磷的平均值由(2.56±0.76﹚mmol/L降至(1.93±0.60﹚mmol/L,血磷>1.78 mmol/L患者由100%降至47.4%。结论责任护士对血液透析患者进行健康教育可以明显降低高磷血症的发生率。

Effect of Health Education on Patients with Hemodialysis Combined with Hyperphosphatemia

Objective To reduce the incidence of hyperphosphatemia of patients with hemodialysis by health education. Methods 76 cases of patients meeting the inclusion criteria of hemodialysis center of the affiliated Zhongshan Hospital of Xiamen University from January 2014 to April 2014 were selected as the research object and given a questionnaire survey including the knowledge degree of high phosphorus food, phosphorus intake in daily diet and the application of phosphate binder, the possible causes of hyperphosphatemia were analyzed, the patients and their families were repeatedly given indi-vidualized publicity and education and the correct guidance, the patients were given hollow blood phosphorus determination before the propaganda and education and after 3 months of propaganda and education, the blood phosphorus level , the ap-plication amount of phosphate binder and the incidence of hyperphosphatemia before and after propaganda and education were compared. Results Before health education, the number of people with the knowledge of high phosphorus food types was 18 and increased to 56 after propaganda and education, the average hollow blood phosphorus value was (2.56±0.76) mmol/L of the 76 cases of patients with hemodialysis before propaganda and education, the main causes of hyperphosphatemia in-cluded 4 kinds of situations: too much pure phosphorus intake, inappropriate use of pure phosphate binder, no taking phos-phate binder and too much pure phosphorus intake combined with inappropriate use of phosphate binder, and they respectively accounted for 25.0%, 42.1%, 15.8%and 13.2%;the mean hollow blood phosphorus value decreased from (2.56±0.76)mmol/L to (1.93 ±0.60)mmol/L, the percentage of patients whose blood phosphorus >1.78 mmol/L decreased from 100% to 47.4%. Conclusion Health education from primary nurses for patients with hemodialysis can obviously decrease the incidence of hyperphosphatemia.