营养治疗对维持血透患者的疗效观察

The effects of nutrition therapy on maintenance hemodialysis patient.

目的 :探讨营养治疗对维持血透 (MHD)患者的疗效。方法 :15例维持血透的患者被随机分成治疗组 (营养治疗联合血透 )和对照组 (单纯采用血透 )。治疗组采用的营养治疗的措施是 :1、热能供应为30～35kcal·kg-1·d-1;2、蛋白质供应为1 0～1 2g·kg-1·d -1 ,其中优质蛋白质占50 %以上 ;3、采用高钙低磷的饮食 (每日钙摄入量大于1000mg,磷摄入量小于1200mg) ;4、限制钾钠的饮食 (每日钾摄入量小于2 0g,氯化钠3～5g)。而对照组则采用自由饮食。结果 :治疗组血透前血清钾和尿素/肌酐比值均显著降低 (P<0 05) ,血浆白蛋白显著升高 (P<0 05) ;对照组患者除尿素/肌酐比值升高 (P<0 05)外 ,其它指标变化不明显(P>0 05)。三个月后两组患者比较发现 :血透前血清钾和尿素/肌酐比值均显著降低 (P<0 05) ,血浆白蛋白显著升高 (P<0 05)。结论 :饮食对控制血液透析患者透前血清钾、尿素/肌酐比值和血浆白蛋白的水平有重要意义 ,合理营养可使血透患者透前血清钾和尿素/肌酐比值明显降低 。

Objects:This study is to perceive the effects of nutrition therapy on maintenance hemodialysis(MHD) patients.Methods:15 cases are selected and divided into two groups randomly:therapy group 7 patients,2 male and 5 female,(45.5±11.7)years and control group 8 patients,3 male and 5 female,(47.5±12.5)years.Measures are adopted for therapy patients as followed:1.Energy supply:30～35kcal/kg ideal body weight/day;Protein supply:1.0～1.2g/kg ideal body weight/day(the proporation of good protein is beyond 50%);2.Higher calcium and lower phosphorus diet(calcium intake is beyond 1000mg/day and phosphrous intake not more than 1200mg/day);3.Limited kalium and sodium diet(kalium intake not more than 2.0g/day and salt intake not more than 3～5g/day);but the control patients adopt free diet.Results:Three months later,the results show that the value of serum kalium and the ratio of BUN/Scr decrease apparently(P<0.05),whereas serum albumen increases sufficiently(P<0.05).The other indexes of the therapy patients do not change(P>0.05).As for control patients,except the ratio of BUN/Scr increase largely(P<0.05),the other indexes do not change(P>0.05).Comparision of indexes in two groups after three month shows that the value of serum kalium and the ratio of BUN/Scr decrease apparently(P<0.05),whereas serum albumen increases sufficiently(P<0.05).Conclusion:It can be drown a conclusion that reasonable diet advice plays an important role in comtrolling the indexes(including serum kalium,the ratio of BUN/Scr and serum ALB).It makes the indexes(including serum kalium,the ratio of BUN/Scr) decrease and makes the value of serum ALB increase sufficiently.