飲食干預對腹膜透析患者營養狀態的影響

袁忠勇　李筱　林騰強　葉曉藝　毛石清　邱錦霖

[摘要] 目的 探討飲食干預對腹膜透析患者營養狀態的影響。 方法 隨機從我院2014年3月～2017年5月期間收治的腹膜透析患者中抽取80例納入到研究中，用隨機數字法分為兩組，每組40例。對照組接受常規腹膜透析，研究組在腹膜透析治療基礎上接受飲食干預，觀察兩組治療狀況，如營養狀況、腎功能等指標，并進行比較。 結果 干預前，兩組腎功能指標比較，差異無統計學意義（P>0.05）；干預后，研究組Cre、BUN指標均低于對照組（P<0.05）。干預前兩組體重、HGB、Alb、TP、HbA1c、TC、TRIG、HDL、hs-CRP指標比較，差異無統計學意義（P>0.05）；干預后兩組HbA1c、TC、TRIG、HDL指標比較差異無統計學意義（P>0.05）；但干預后體重、HGB、Alb、TP、hs-CRP指標，研究組優于對照組（P<0.05）。 結論 給予腹膜透析患者飲食干預，在改善患者腎功能上作用突出，有助于確保患者營養狀態，緩解微炎癥癥狀，值得推廣。

[關鍵詞] 營養狀態；腹膜透析；飲食干預

[中圖分類號] R473 [文獻標識碼] B [文章編號] 1673-9701（2017）36-0042-03

[Abstract] Objective To study and discuss the influence of dietary intervention for nutritional status of peritoneal dialysis patients. Methods A total of 80 cases of patients with peritoneal dialysis who accepted treatments in this hospital from March 2014 to May 2017 were selected and included in the discussion， and were randomly divided into two groups， with 40 cases in each group. The control group were received routine peritoneal dialysis，while the study group were treated with peritoneal dialysis， and then were received dietary intervention. Then， the treatment status of two groups were observed， such as serum calcium， phosphorus were compared. Results There was no significant difference between the two groups in renal function before intervention（P>0.05）； after intervention， the indexes of Cre and BUN in the study group were lower than those in the control group（P<0.05）. The body weight， HGB， Alb， TP， HbA1c， TC， TRIG， HDL and hs-CRP indexes before intervention were compared， and there was no significant difference between the two groups（P>0.05）； there was no significant difference between the two groups in HbA1c， TC， TRIG and HDL indexes after intervention（P>0.05）； but the weight， HGB， Alb， TP， hs-CRP indexes after the treatment were compared， the study group was better than the control group（P<0.05）. Conclusion It is recommended to give peritoneal dialysis patients dietary intervention， which in the improvement of renal function in patients with prominent role， and to ensure the nutritional status of patients， relieve micro inflammatory symptoms，thus it is worth promoting.

[Key words] Nutritional status； Peritoneal dialysis； Dietary interventions

終末期腎病患者較為常用的一種腎臟代替性療法則為腹膜透析，經過多年發展，腹膜透析治療方式已取得較大進展[1]。現接受腹膜透析治療的患者例數正逐年攀升，而此類患者中，大部分均存在程度不同的營養不良，不僅對患者生活質量造成影響，且會降低其免疫功能，并發多種感染性疾病，且和影響透析人員喪失生命的首要原因心血管疾病存在密切性關系[2]。隨著醫學技術逐步發展，腹膜透析技術也得到相應改良，但心血管疾病和營養不良仍然是對腹膜透析患者預后造成影響的一個重要因素[3]。且因腹膜透析中存在營養丟失、蛋白漏出等缺陷，進一步突顯了飲食管理的重要性。同時，生理病理學也重點強調了腹膜透析患者飲食干預的必要性和重要性。為此……