老年肿瘤患者入院时低摄入性脱水的评估及原因分析

doi:10.3761/j.issn.0254-1769.2023.16.008

摘要/Abstract

摘要：

目的评估老年肿瘤患者入院时低摄入性脱水状况，并分析其原因和护理对策，为护理人员早期识别低摄入性脱水，并及时干预提供参考。方法采用便利抽样法，选取2021年3月—2022年3月天津市某三级甲等医院住院24 h内的老年肿瘤患者，通过计算血浆渗透压判断患者低摄入性脱水的发生情况，根据血浆渗透压值将患者分为正常组和脱水组，采用Logistic回归分析筛选老年肿瘤患者低摄入性脱水的原因。结果 706例老年肿瘤患者中，入院时低摄入性脱水发生率为60.91%。Logistic回归分析结果显示，合并认知障碍（OR=2.018）、合并吞咽障碍（OR=1.611）、Barthel指数评分≤60分（OR=2.572）、血清白蛋白<35 g/L（OR=2.698）和病程>6个月（OR=2.905）是低摄入性脱水的原因（P<0.05）。结论老年肿瘤患者入院时低摄入性脱水发生率高，合并认知障碍、合并吞咽障碍、Barthel指数评分≤60分、血清白蛋白<35 g/L和病程>6个月的老年肿瘤患者，更易发生低摄入性脱水。护理人员应密切关注高风险患者，早期识别并采取合适的干预措施，降低低摄入性脱水的发生率。

关键词: 肿瘤, 老年人, 脱水, 评估, 护理

Abstract:

Objective To assess the status and analyze the causes of low intake dehydration in elderly patients with cancer at admission，and to provide references for early clinical recognition and prompt intervention. Methods From March 2021 to March 2022，elderly patients with cancer who had been hospitalized within 24 h in a tertiary A hospital in Tianjin were selected by convenience sampling method. The occurrence of low intake dehydration was judged by the calculated plasma osmolality，and the patients were divided into a normal group and a dehydrated group according to the plasma osmolality values，and the influencing factors for the occurrence of low intake dehydration in elderly patients with cancer were screened by logistic regression analysis. Results Among 706 elderly patients with cancer，the incidence of low intake dehydration during admission was 60.91%. Logistic regression analysis showed that comorbid cognitive impairment（OR=2.018），comorbid swallowing disorder（OR=1.611），Barthel score≤60 points（OR=2.572），serum albumin<35 g/L（OR=2.698） and duration of illness>6 months（OR=2.905） were influencing factors of low intake dehydration（P<0.05）. Conclusion Elderly cancer patients who have a high incidence of low intake dehydration on admission and comorbid cognitive impairment，comorbid swallowing disorders，Barthel score≤60 points，serum albumin<35 g/L and duration of illness>6 months are more likely to develop low intake dehydration，and nursing staff should pay close attention to high-risk patients to identify and plan suitable interventions early to reduce the incidence of low intake dehydration.

Key words: Neoplasms, Aged, Dehydration, Assessment, Nursing Care

郑晓玲, 陈希伟, 陈小岑, 杨可莹, 李红兴, 陆亚楠. 老年肿瘤患者入院时低摄入性脱水的评估及原因分析[J]. 中华护理杂志, 2023, 58(16): 1964-1969.

ZHENG Xiaoling, CHEN Xiwei, CHEN Xiaocen, YANG Keying, LI Hongxing, LU Yanan. Assessment and causes of low intake dehydration in elderly patients with cancer at admission[J]. Chinese Journal of Nursing, 2023, 58(16): 1964-1969.

图/表 3

表1 老年肿瘤患者低摄入性脱水的单因素分析[n=706，例（百分比，%）]

Table 1 Univariate analysis of low intake dehydration among elderly patients with cancer[n=706，cases（percentage，%）]

表2 自变量的赋值方法

Table 2 Independent variable assignment

表3 老年肿瘤患者低摄入性脱水的二元Logistic回归分析

Table 3 Results of Logistic regression analysis of factors affecting low intake dehydration among elderly patients with cancer

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