基于人体成分分析的精准管理在老年血液透析患者中的应用

Effects of precise management based on human component analysis on blood pressure and nutrition status in elderly hemodialysis patients

目的:探讨基于人体成分分析的精准管理对老年血液透析患者血压及营养状况的影响。方法:采用便利抽样法,选取2021年1—5月在首都医科大学附属北京友谊医院血液净化中心进行规律血液透析的144例老年患者为研究对象,按照随机数字表法将其分为对照组和观察组,各72例。对照组采用常规容量及营养管理,观察组在对照组基础上采取基于人体成分分析的容量及营养精准管理,共12周。比较两组患者水负荷值、营养相关指标、干预期内上机前平均血压和透析低血压发生率。结果:干预后观察组水负荷值低于对照组,差异有统计学意义(P<0.01)。干预期内观察组上机前平均血压低于对照组,差异有统计学意义(P<0.01)。观察组和对照组透析低血压总发生率分别13.27%(86/648)、17.44%(113/648),差异有统计学意义(χ^(2)=4.428,P=0.035)。观察组干预后白蛋白、肌肉量、身体细胞量及瘦体重较干预前升高,血磷及改良主观全面营养评估(SGA)得分较干预前下降,差异均有统计学意义(P<0.05);干预后观察组白蛋白、肌肉量、身体细胞量及瘦体重高于对照组,血磷及改良SGA得分低于对照组,差异均有统计学意义(P<0.05)。结论:基于人体成分分析的容量及营养精准管理可以有效改善老年血液透析患者容量超负荷、血压及营养状况,降低高磷血症及透析低血压的发生率。

Objective To explore the effects of precise management based on human component analysis on blood pressure and nutrition status of elderly hemodialysis patients.Methods From January 2021 to May 2021,a total of 144 patients undergoing regular hemodialysis in Beijing Friendship Hospital Affiliated to Capital Medical University were enrolled and divided into the control group and the observation group with 72 cases in each group by the random number table method.The control group received routine volume and nutrition management,and the observation group received accurate volume and nutrition management based on human composition analysis for 12 weeks.The differences of water load(OH),nutrition-related indicators,mean blood pressure before machine operation and incidence of hypotension during the intervention were compared in the two groups.Results After the intervention,the OH value of the observation group was lower than that of control group,the difference was statistically significant(P<0.05).During the intervention period,the average blood pressure of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).The total incidence of hypotension in the observation group and the control group were 13.27%(86/648)and 17.44%(113/648)respectively,the difference was statistically significant(χ2=4.428,P=0.035).After the intervention,albumin,muscle mass,body cell mass and lean body weight of the observation group increased,while blood phosphoru and improved Subjective Global Assessment(SGA)score decreased,and the differences were statistically significant(P<0.05).After the intervention,albumin,muscle mass,body cell mass and lean body weight of the observation group were higher than those of the control group,while blood phosphorus and improved SGA score were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusions Precise management of volume and nutrition based on human component analysis can effectively improve volume overload,blood pressure and nutrition status of elderly hemodialysis patients,and reduce the incidence of hyperphosphatemia and dialysis hypotension.