个体化医学营养疗法在终末期肾病血液透析患者中的应用效果研究

Effects of individualized medical nutrition therapy on patients with end-stage renal disease receiving hemodialysis

目的探究个体化医学营养疗法在终末期肾病血液透析患者中的应用效果。方法采用便利抽样法，选取2015年7月-2017年6月在首都医科大学附属北京康复医院接受血液透析的82例终末期肾病患者作为研究对象，按照治疗时间分为对照组和观察组，每组41例。对照组患者采用常规护理，观察组在对照组的基础上采用个体化医学营养疗法护理，连续护理3个月。比较两组患者的营养状况、生活质量和不良反应发生情况。结果干预前，两组营养状况和生活质量各维度得分差异均无统计学意义（P〉0．05）。干预后观察组BMI、血红蛋白、血浆白蛋白、肌酐水平及生活质量各维度得分高于对照组，差异有统计学意义（P〈0．05），营养不良一炎症评分（MIs）低于对照组，差异均有统计学意义（P〈0．05）。干预后观察组不良发应发生率低于对照组，差异有统计学意义（P〈0．05）。结论个体化医学营养疗法能够有效改善血液透析患者的营养状况，提高患者的生活质量评分，降低不良反应发生率。

Objective To explore the effects of individualized medical nutrition therapy on patients with end-stage renal disease receiving hemodialysis. Methods Totally 82 patients with end-stage renal disease who received hemodialysis in Beijing Rehabilitation Hospital of Capital Medical University between July 2015 and June 2017 were selected by convenient sampling and randomized divided into the control group （n=41） and the observation group （n=41） according to the treatment time. Patients in the control group received conventional nursing, while patients in the observation group received individualized medical nutrition therapy on this basis for three consecutive months. Nutritional status, quality of life and adverse effects were compared between the two groups. Results There was no significant difference in nutritional status and quality of life between the two groups before intervention （P 〉 0.05）. However, the observation group scored higher in body mass index （BMI）, hemoglobin （HGB）, plasma-albumin （Alb）, creatinine （CRE） and quality of life than the control group post intervention （P 〈 0.05）, while its malnutrition-inflammation score （MIS） was lower than that of the control group （P 〈 0.05）. The incidence rate of adverse effects was lower in the observation group than in the control group （P 〈 0.05）. Conclusions Individualized medical nutrition therapy can effectively improve the nutritional status and quality of life, as well as reduce the incidence rate of adverse effects in the patients with end-stage renal disease who receive hemodialysis.