营养规范化护理管理模式对肾性骨营养不良患者维持性血液透析骨代谢水平的影响

Effect of Standardized Nutrition Nursing Management Mode on Bone Metabolism Level in Patients with Renal Bone Dystrophy During Maintenance Hemodialysis

目的:探讨营养规范化护理管理模式对肾性骨营养不良患者维持性血液透析骨代谢水平的影响.方法:选择2020年12月—2022年12月在天津市泰达医院进行维持性血液透析的80例肾性骨营养不良患者为研究对象,按随机数字表法将其分为对照组与观察组,各40例.对照组采用常规护理,观察组在对照组基础上采用营养规范化护理,2组护理时间均为3个月.对比2组残余肾功能、骨代谢情况、遵医情况、并发症发生情况.结果:观察组服药、饮食、运动依从性,均高于对照组,组间差异有统计学意义(P<0.05).护理后,尿素氮值、肌酐值均低于护理前,观察组尿素氮值、肌酐值均低于对照组,差异有统计学意义(P<0.05).血钙含量高于护理前,甲状旁腺激素、血磷、碱性磷酸酶含量均低于护理前,且观察组甲状旁腺激素、血钙、血磷、碱性磷酸酶均低于对照组,差异有统计学意义(P<0.05).观察组并发症总发生率为2.50%,低于对照组的15.00%,差异有统计学意义(P<0.05).结论:营养规范化护理管理模式在肾性骨营养不良患者维持性血液透析应用时,可改善肾功能,提高患者的服药、饮食、运动依从性,改善患者的骨代谢水平,降低并发症发生率.

Objective:To explore the effect of standardized nutrition nursing management model on bone metabolism level in patients with renal osteodystrophy during maintenance hemodialysis.Methods:80 patients with renal osteodystrophy who underwent maintenance hemodialysis in Tianjin Teda Hospital from December 2020 to December 2022 were selected as the study objects,and were divided into a control group and an observation group according to random number table method,with 40 cases in each group.The control group received routine nursing,and the observation group received standardized nutrition nursing on the basis of the control group.The nursing time of both groups was 3 months.Residual renal function,bone metabolism,compliance and complications were compared between the two groups.Results:The compliance of medication,diet and exercise in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After nursing,the urea nitrogen value and creatinine value were lower than before nursing,and the urea nitrogen value and creatinine value in observation group were lower than control group,the difference was statistically significant(P<0.05).The content of blood calcium was higher than before nursing,the contents of parathyroid hormone,blood phosphorus and alkaline phosphatase were lower than before nursing,and the contents of parathyroid hormone,blood calcium,blood phosphorus and alkaline phosphatase in observation group were lower than those in control group,with statistical significance(P<0.05).The total incidence of complications in the observation group was 2.50%,lower than 15.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Nutritional standardized nursing management mode can improve renal function,improve patients'compliance with medication,diet and exercise,improve patients'bone metabolism level,and reduce the incidence of complications in patients with renal osteodystrophy undergoing maintenance hemodialysis.