维持性血液透析患者营养状况及其影响因素分析

Nutritional status and influence factors of maintenance hemodialysis patients

目的 观察分析维持性血液透析（maintenance hemodialysis,MHD）患者营养状况及其影响因素,提出相应的防治对策.方法 选取本中心MHD患者103例,采用改良定量主观整体评估表进行营养状况评估,将患者分为营养正常组（评分≤10分）和营养不良组（评分＞10分）,分析影响MHD患者营养不良的相关因素.结果 103例MHD患者中,营养正常组59例,营养不良组44例,营养不良发生率为42.72％.多因素Logistic回归分析结果显示：增龄[95％CI（1.004,1.072）,P=0.027]、糖尿病[95％ CI（1.113,16.143）,P=0.034]、肾病营养知识知晓率低[95％ CI（1.253,12.531）,P=0.019]为MHD患者发生营养不良的危险因素.结论 MHD患者营养不良发生率高,年龄、糖尿病、肾病营养知识知晓率与患者发生营养不良有关.临床工作中应采取有效合理的干预方法加强营养,改善患者营养状况.

Objectives To investigate the nutritional status and influence factors of maintenance hemodialysis （MHD） patients and propose the corresponding countermeasures.Methods A total of 103 MHD patients were selected in the central who were divided into the normal nutrition group （score ≤ 10） and malnutrition group （score 〉 10） by modified quantitative subjective global assessment （MQSGA） form.Then,the corresponding factors affecting the malnutrition of MHD patients were analyzed.Results Within the 103 MHD patients,59 patients were classified into the normal nutrition group,and 44 patients were in the malnutrition group taking 42.72%.Based on the multivariable logistic regression analysis,it was found that the dangerous factors for the occurrence of malnutrition in MHD patients include increasing age [95% CI（1.004,1.072）,P =0.027],suffering from diabetes [95% CI（1.113,16.143）,P =0.034],and knowing little knowledge about nephropathy nutrition [95%CI（1.253,12.531）,P=0.019].Conclusions According to the factors affecting the nutrition status of MHD patients,one can effectively improve the nutritional status of patients,and reduce the occurrence of malnutrition through increasing the nutrition screening frequency of patients with high age and diabetes history,early detection and intervene,and the improvement of the nutritional knowledge of MHD patients in the clinical work.