Study On The Dehydration And Its Influencing Factors In Stroke Patients At Different Stages

Objective To describe the dehydration status of stroke patients and the changes of dehydration in the acute phase and convalescent phase,to explore the influencing factors of dehydration status in stroke patients,and to identify the risk factors of dehydration.The aim is to provide theoretical basis for the prevention and treatment of dehydration in clinical work,reduce the incidence of dehydration in stroke patients,and the adverse effects caused by dehydration,improve the health level of patients and improve the quality of daily nursing service.Methods This study is divided into two parts.The first part: longitudinal study,using convenience sampling method.A total of 86 stroke patients with acute phase who received continuous rehabilitation treatment in the Second Affiliated Hospital of Anhui Medical University from February 2018 to February 2020 were selected.The general information and biochemical indicators of patients were collected at the time of admission in the acute phase to understand the dehydration status of the patients.The patients were followed up for rehabilitation treatment at the convalescent phase.Biochemical indexes of patients were collected again to understand the dynamic changes of patients' dehydration.The second part: cross-sectional study,using convenience sampling method.From June 2018 to July 2020,119 patients with acute stroke and 263 patients with convalescent stroke were selected.General information questionnaire,ADL,NIHSS,GCS,water drinking test,24-hour liquid intake recording method and m RS were used to investigate the influencing factors of dehydration,analyze the dehydration occurrence,make univariate analysis on each variable,and make logistic Return analysis on the significant independent variables in univariate analysis to explore the influencing factors of dehydration.Results(1)In the longitudinal study of 86 patients,with blood osmotic pressure > 295mmol/L as the critical value of dehydration,57 cases of acute dehydration,the incidence of dehydration was 66.28%,49 cases of convalescent dehydration,the incidence of dehydration was 56.98%.Among them,21 patients(24.42%)experienced dehydration in the acute phase and improved in the convalescent phase;Dehydration occurred in 36 patients(41.86%)during the acute phase and remained during the convalescent phase.13 patients(15.12%)had no acute dehydration,but occurred in the convalescent phase.16 patients(18.60%)did not develop dehydration during the acute and convalescent phases.(2)In the cross-sectional study,75 of 119 patients with acute stroke were dehydrated,and the incidence of dehydration was 63%.Univariate analysis showed that there were significant differences between the dehydration group and the non dehydration group in the type of stroke,history of stroke,use of hypoglycemic drugs,use of lipid regulating drugs,and daily average drinking water consumption.Multivariate analysis showed that with the increase of daily water intake,the occurrence of dehydration was significantly reduced(P < 0.05),and the use of anti-diabetes drugs was a risk factor for dehydration in the acute phase of stroke patients.(3)In a cross-sectional study of 263 stroke convalescent patients,144 were dehydrated,with an incidence of dehydration of 54.75%.Univariate analysis showed that there were significant differences between the dehydration group and the non dehydration group in gender,aphasia,heart disease,?-blocker,hypoglycemic drugs,lipid regulating drugs,prealbumin level,and daily average drinking water consumption(P<0.05).Multivariate analysis showed that the use of antidiabetic drugs was a risk factor for dehydration in stroke patients during convalescence.Conclusions(1)The incidence of dehydration in stroke patients in China is higher in both acute and recovery stages.(2)The dehydration status of stroke patients is dynamic.In each stage of stroke course,relevant assessment should be carried out in time,find dehydration in time and give preventive measures in time.(3)Women are more prone to dehydration in stroke patients with convalescence phase,and the use of ?-blocker,hypoglycemic drugs,and lipid-regulating drugs increases the risk of dehydration.(4)The majority of stroke patients can not maintain good drinking habits,their intake of oral fluid is significantly insufficient,which increases the risk of dehydration.In clinical work,we should pay attention to patients' daily drinking water consumption,strengthen health education,and make feasible drinking water plans for patients.