营养支持在肾移植围手术期的应用

Study on nutritional support in early postoperative renal transplant patients

目的探讨肾移植围手术期的营养支持。方法对163例肾移植患者围手术期营养支持方案和营养状况进行回顾性分析。根据患者手术前后2周内实际营养摄入量的不同分为实验组(相对高氮摄入量组,n=89)和对照组(相对低氮摄入量组,n=74)。对比其术后第2周末的氮平衡、体重、血清蛋白及血红蛋白、血脂、肾功能的变化情况。结果实验组氮平衡显著优于对照组;两组间体重无明显差异;实验组血清蛋白明显高于对照组;两组血红蛋白无显著差异;两组血脂术后除载脂蛋白AI实验组显著高于对照组外,其他指标差异不显著;对照组肾功能指标恢复明显好于实验组。结论肾移植术后早期仍应控制氮的摄入量,尽量减轻移植肾的负担,保护移植肾的功能。

Objective To investigate the nutritional support in early postoperative renal transplant patients. Methods The early intake and nutrition were analyzed in 163 patients who received renal allograft transplantation. The patients were divided into two groups： the study group （89 patients, higher amount of nitrogen intake） and the control group （74 patients, lower amount of nitrogen intake）, according to the different amount of actural nutritional intake during two postoperative weeks. Two weeks after the operation, changes of the nitrogen balance, weight, albumin, hemoglobin, serum lipids and renal function were evaluated. Results The nitrogen balance in the study group was better than that in the control group, but there was no significant difference in weight between the two groups. The level of serum albumin in the study group was higher than that in the control group, but there was no significant difference in hemoglobin level between the two groups. The level of Apo-AI in the study group was higher than that in the control group. There was less improvement of renal function in the study group than in control group. Conclusion Nitrogen intake in early post-operative renal transplant patients should be controlled so that the transplanted kidney can work better.