- 期刊
降磷藥物及飲食教育方案對於血液透析患者高血磷症控制之成效
Effctiveness of Phosphorous Educational Program for the Control of Hyperphosphatemia amongst Dialysis Patients
摘要
目的：探討降磷藥物及飲食教育方案對於血液透析患者高血磷症控制的成效。材料及方法：採前實驗研究設計，於高雄市採簡單隨機取樣抽取7所各級醫院洗腎室作為收案地點。選取每星期行三次逢液透析之末期腎病患者，同時血中磷濃度≧6 mg/dL且尚未發生異位性鈣化及副甲狀腺素小於600 pg/dL者為研究對象。共收集27名有效個案之資料。介入措施（含記錄每日飲食、藥物及高血磷症自我照顧手冊）實施之前，受試者先記錄一星期飲食及藥物服用情形並檢驗血中磷值，之後給予六次衛教活動並於二週內完成。介入措施結束後再記錄一星期飲食及藥物服用情形並檢驗血中磷值。結果：（1）降磷教育方案實施前，血液透析之高血磷症患者平均每日每公斤攝取的磷量在正常範圍內，血磷平均為7.24±1.00 mg/dL。（2）降磷教育方案實施前，血液透析之高血磷症患者服用磷結合藥物的自我照顧行為，包括服藥物的次數、服用藥物的方法及藥物的劑量都有明顯有不遵從的情形。（3）降磷教育方案實施後血磷平均值下降為5.56 mg/dL。結論：降磷教育方案能顯著地增進患者採取低磷飲食及服用磷結合藥物的自我照顧行為，同時顯著地降低血中磷值。
並列摘要
Objective: The purpose of this study was to evaluate the effectiveness of phosphorous-controlling medication and a dietary educational program for the control of hyperphosphatemia for dialysis patients. Materials and Methods: A pre-experimental research design was used for this study. Twenty-seven subjects were randomly recruited from seven hemodialysis units in Kaohsiung City. Subjects recorded daily diet and took phosphate binders for a week, subsequently having the phosphorous level of their blood checked. The subjects participated in six phosphorous-related educational activities over a two week period, following which, the subjects again recorded daily diet and took phosphate binders for a week, then had the phosphorous level of their blood checked again. Results: (1)Prior to their phosphorus educational program, the average quantity of dietary phosphate consumed by subjects (kg/D) was in the normal range. (2) Prior to intervention, subjects did not regularly take phosphate-binding medication including frequency, method, and dose of phosphorous medication. (3) The blood phosphorous level of the subjects was significantly decreased following their phosphorus educational program. Conclusions: The subjects’ activity incorporating eating a low phosphorous diet and taking phosphate binding medication was significantly enhanced after participating in a phosphorous medication and diet educational program. Accordingly, the subjects blood phosphorous level decreased significantly.