目的：通过比较糖尿病腹膜透析与无糖尿病腹膜透析患者液体摄入健康信念及容量状况，明确糖尿病腹膜透析患者液体摄入健康信念与容量状况的相关性。方法选取2014年1月—2015年1月于宁夏医科大学总医院腹膜透析中心接受腹膜透析治疗的患者156例为研究对象。根据患者是否伴有糖尿病，将患者分为糖尿病组（36例）和无糖尿病组（120例）。由经过统一培训的调查人员采用健康信念量表进行调查，各分量表所有条目的评分累计即为该分量表总分。由专职护士测量并记录患者体质量、舒张压，评估患者水肿严重程度。采用生物电阻抗仪测量患者体内水负荷（OH）、细胞外液（ECW）、细胞内液（ICW）以及细胞外液与细胞内液比值（E/ I）。记录患者透析剂量、透析液葡萄糖浓度、超滤量、饮水量及尿量，采用生化自动分析检测仪测定血清清蛋白、血尿素氮、血肌酐、血糖、血钠水平。结果两组患者感知维持容量平衡障碍、感知容量平衡易感性和液体摄入自我效能分量表评分比较，差异均无统计学意义（P >0.05）。糖尿病组感知容量平衡益处和感知容量失衡严重性分量表评分低于无糖尿病组，差异有统计学意义（P <0.05）。两组体质量、舒张压及水肿程度比较，差异均有统计学意义（ P <0.05）。糖尿病组 OH、ECW、ICW 水平高于无糖尿病组，E/ I 低于无糖尿病组，差异均有统计学意义（P <0.05）。糖尿病组透析剂量、透析液葡萄糖浓度、饮水量及清蛋白、血糖水平比较，差异均有统计学意义（P <0.05）。糖尿病组无水肿与水肿患者感知容量平衡益处、感知容量失衡严重性、感知容量平衡易感性及液体摄入自我效能分量表评分比较，差异均无统计学意义（P >0.05）。糖尿病组水肿患者感知维持容量平衡障碍分量表评分高于无水肿患者，差异有统计学意义（ P <0.05）。结论糖尿病腹膜透析患者水肿严重程度高于无糖尿病腹膜透析患者，可能与糖尿病腹膜透析患者对容量失衡不良后果认识不足，釆取限制水盐摄入的健康行为缺失，对液体摄入量限制依从性较差有关。%Objective To compare the health belief of fluid intake and volume load of diabetes patients receiving peritoneal dialysis,and clarify the correlation between the health belief of fluid intake and volume load. Methods From January 2014 to January 2015,we enrolled 156 patients who received peritoneal dialysis in the peritoneal dialysis center of the General Hospital of Ningxia Medical University. According to the existence of diabetes,the patients were divided into two groups:diabetic group(n = 36)and non - diabetic group( n = 120). By unified training,the health belief scale was employed to conduct surveys,the accumulated total of the item scores of each subscale was the total score. The body weight and diastolic pressure of the patients were measured by special nurses,and the edema degree of patients was evaluated. Using bioelectrical impedance instrument,the OH,ECW,ICW and E/ I were examined. The dialysis dosage,dialysis glucose concentration,ultrafiltration volume,water intake and urine volume were recorded,and the automatic biochemical analysis was conducted to examine the levels of serum albumin,blood urea nitrogen,serum creatinine,blood glucose and plasma sodium. Results The two groups were not significantly different in the scores of the subscales of perception maintaining capacity balance barrier,perception capacity balance susceptibility,and fluid intake self - efficacy(P > 0. 05). Diabetes group was lower than non - diabetic group in the scores of the subscales of perception capacity balance benefits and perceived capacity balance severity(P < 0. 05). The two groups were significantly different in body weight,diastolic pressure and edema degree( P < 0. 05). Diabetic group was higher than non - diabetic group in the levels of OH,ECW and ICW,and was lower than non - diabetic group in E/ I( P <0. 05). Diabetic group was significantly different from non - diabetic group in dialysis dose,dialysate glucose concentration, water intake,albumin and blood glucose(P < 0. 05). In diabetic group,patients with edema and patients without edema were not significantly different in the scores of the subscales of perception capacity balance benefits,perceived capacity balance severity,perception capacity balance susceptibility,and fluid intake self - efficacy( P > 0. 05). In diabetic group,patients with edema were higher than patients without edema in the scores of the subscale of perception maintaining capacity balance barrier (P < 0. 05). Conclusion Diabetic patients receiving peritoneal dialysis have higher edema degree than non - diabetic patients receiving peritoneal dialysis. That may be associated with the inadequate understanding of the adverse outcomes of capacity imbalance,the lack of healthy behaviors of the restriction on water and salt intake,and poor compliance with the restriction on fluid intake volume.
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