强化营养护理对维持性血液透析患者营养状况影响.docVIP

强化营养护理对维持性血液透析患者营养状况影响 　　[摘要] 目的 探讨强化营养护理对维持性血液透析（MHD）患者营养状况的影响。 方法 以在我院血液净化中心行MHD的患者为研究对象，随机分成干预组和对照组。干预组在常规护理基础上给予强化营养护理，对照组进行常规护理。比较半年后两组患者的营养状况。 结果 强化营养护理半年以后，干预组MIS和MQSGA评分显著低于对照组，差异有统计学意义（P ＜ 0.01）；干预组血白蛋白显著高于对照组，差异有统计学意义（P ＜ 0.01）。 结论 强化营养护理可以改善MHD患者的营养状况。 　　[关键词] 维持性血液透析；营养；护理；营养不良-炎症评分 　　[中图分类号] R459.5；R473.5 [文献标识码] B [文章编号] 1673-9701（2012）04-0133-02 　　 　　The effect of nutritional nursing on nutritional status in patients with maintenance hemodialysis 　　ZHAN Haixia 　　Department of Gastroenterology, the First People’s Hospital of Wenling City, Wenling 317500, China 　　[Abstract] Objective To know the efficacy of nutritional nursing on nutritional status in patients on maintenance hemodialysis. Methods A total of 128 patients came from the hemo-purified center of our hospital were randomly divided into the observed group and the compared group. The observed group received the intensive nutritional nursing care and routine nursing care, but the compared group received the routine nursing care only. The nutritional parameters were compared between the two groups after 6 months. Results After 6 months of intensive nutritional nursing, MIS and MQSGA were significantly lower (P ＜ 0.05); BUT serum albumin was significantly higher in observed group than that of compared group (P ＜ 0.05). Conclusion Nutritional nursing is a good method to improve the nutritional status of MHD patients. 　　[Key words] Hemodialysis; Malnutrition; Nutritional nursing; Malnutrition-inflammation score 　　 　　营养不良是维持性血液透析（maintenance hemodialysis，MHD）患者高住院率和高死亡率的重要原因[1]。然而，缺乏有效的营养治疗方法、营养元素摄入不足是MHD患者营养不良的首要原因[2]。本研究对我院行MHD患者进行强化营养护理，改善了患者的营养状况，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择2009年5月～2010年5月在我院血液??化中心行MHD的128例患者为研究对象，随机分成干预组和对照组各64例。干预组在监测生命体征、指导起居饮食、血透通路护理等常规护理基础上给予强化营养护理，对照组进行常规护理。比较半年后两组患者的营养状况。 　　1.2 强化营养护理方法 　　1.2.1 确定营养摄入目标 蛋白质摄入（1.2～1.3）g/（kg?d）[3]；热量摄入（138.07～146.44）kJ/（kg?d）[4]；糖摄入（5～6）g/（kg?d）；脂肪摄入（1.3～1.7）g/（kg?d）。 　　1.2.2 患者常用食物的调查 每位患者罗列出20种以上最常用的食物，按照最常吃在先、次常吃在后的