肾移植术后患者的营养状况评价

Nutritional assessment of patients after renal transplant

目的:调查肾移植术后患者的营养状况,探寻合理的临床营养治疗方案。方法:抽取2002-10/2006-09于江苏省中医院住院的肾移植术后1个月患者40例,患者均知情同意,配合各种测量、检查。调查内容:①膳食调查:采用饮食称重法。蛋白质应为总热量的30%～35%,碳水化合物应为50%～60%,脂肪应为10%～15%。②人体测量:包括身高、体质量、三头肌皮褶厚度、上臂围、上臂肌围。③生化实验室检查:包括血浆白蛋白、血胆固醇、血糖、血尿酸、血钾、血钠、总淋巴细胞计数。结果:40例患者全部进入结果分析,无脱落。①肾移植术后患者膳食结构不合理,其中脂肪(38%)和蛋白质(17%)摄入量超标,碳水化合物(45%)摄入不足。②40例患者中高血糖者9例(占22.5%),胆固醇、三酰甘油升高者28例(占70%),血尿酸升高者18例(占45%)。结论:通过营养评价可为改善肾移植术后患者营养状况提供依据,指导患者平衡膳食,维持理想的营养状况。

AIM： To investigate the nutritional status of patients after renal transplant and discuss the proper medical nutrition therapy. METHODS-Forty patients underwent renal transplantation after one month were selected from Jiangsu Provincial Hospital of Traditional Chinese Medicine from October 2002 to September 2006. They were all informed of and agreed with the measurements, which included：①dietary investigation （food weigh）, protein took up for 30%-35% of gross caloric values, carbohydrate for 50%-60%, and fat for 10%-15%;②authropometric measurements （height, weight, triceps skin fold thickness, upper arm circumference, upper arm muscle circumference）; ③biochemical tests （albumin, blood sugar, cholesterol, uric acid, Ka, Na, total lymphocyte count）. RESULTS： All the 40 patients were involved in the result analysis.①Daily food-intake of the patients was unreasonable, protein （17%） and fat （38%） obviously exceeded standard, but the carbohydrate （45%） intake was insufficient.②Moreover the fasting blood sugar increased in 9 postoperative patients （22.5%）, cholesterol and triglyceride increased in 28 （70%）, and blood uric acid increased in 18 （45%）. CONCLUSION： Nutritional investigation provides evidences for improving a balance diet for patients after renal transplant and maintaining a satisfactory nutritional status.