摘要
目的观察饮食指导对维持性血液透析患者营养状况的影响。方法以2008年7月—2010年2月124例维持性血液透析患者为试验组,以2006年1月—2008年6月未进行系统饮食指导的维持性血液透析患者作为对照组。收集并比较患者第1次血液透析和其血液透析后半年的营养指标,包括营养不良-炎症评分(malnutrition inflammation score,MIS)、改良主观营养评分(modified quantitative subjective global assessment of nutrition,MQSGA)、体质量指数、肱三头肌皮褶厚度、上臂围、上臂肌围、血清白蛋白、肌酐、血红蛋白。结果首次透析后试验组和对照组各营养指标间差异无统计学意义(P>0.05);透析半年后试验组MIS和MQSGA均低于对照组,差异有统计学意义(P<0.05),体质量指数、白蛋白、肌酐、血红蛋白两组间比较差异均有统计学意义(P<0.05),试验组高于对照组;试验组患者经过饮食指导透析半年后MIS和MQSGA低于首次透析后,差异有统计学意义(P<0.05),白蛋白、肌酐、血红蛋白比较,差异均有统计学意义(P<0.05),透析半年后高于首次透析后;对照组首次透析后较透析半年后肌酐有所下降,差异有统计学意义,其他各营养指标经比较,差异均无统计学意义(P>0.05)。结论加强饮食指导可以改善维持性血液透析患者的营养状况,但短期内(半年)未能增加脂肪和肌肉含量,故饮食指导是贯穿维持性血液透析患者治疗中的重要护理内容。
Objective To observe the influence of diet guide on nutritional status of patients with maintenance hemodialysis（MHD）.Methods 124 MHD patients with diet guide were taken as experimental group while 80 MHD patients without diet guide as control group.Comparisons were made about the following parameters,including Malnutrition Inflammation Score（MIS）,Modified Quantitative Subjective Global Assessment of Nutrition（MQSGA）;anthropometry including body mass index（BMI）,triceps skinfold（TSF）,mid-arm circumference（MAC） and mid-arm muscle circumference（MAMC）;biochemical assays including albumin,serum creatinine and hemoglobin.Results There was no significant difference of all parameters in two groups after the first hemodialysis（P0.05）.After 6 months of diet guide,MIS and MQSGA were significantly lower,BMI,albumin,serum creatinine and hemoglobin were significantly higher in experimental group than those in control group（P0.05）.After 6 months of diet guide,MIS and MQSGA were significantly lower,albumin,serum creatinine and hemoglobin were significantly higher than those after the first hemodialysis in experimental group（P0.05）.There was no significant difference of the parameters after 6 months of diet guide in control group than those after the first hemodialysis,except serum creatinine.Conclusion Diet guide is a good method to improve the nutritional status of MHD patients but can’t enhance fat content and muscle mass in short term.
出处
《护理学报》
2010年第22期56-59,共4页
Journal of Nursing（China）
基金
温岭市科技计划项目(2009WLCB0085)
