饮食指导配合支持性心理干预治疗对糖尿病肾病腹膜透析患者血糖代谢、肾功能指标及心理健康状态的影响

Effects of dietary guidance combined with supportive psychological intervention on blood glucose metabolism,renal function indexes and mental health status in patients with diabetic nephropathy and peritoneal dialysis

目的:探讨饮食指导配合支持性心理干预治疗对糖尿病肾病腹膜透析患者血糖代谢、肾功能指标及心理健康状态的影响。方法:选择我院2012年9月至2017年8月收治的糖尿病肾病腹膜透析患者70例,按照随机数字表法分为对照组(n=35)和观察组(n=35),对照组给予常规护理,观察组在常规护理基础上进行饮食指导配合支持性心理干预治疗,比较两组患者干预前后血糖[空腹血糖(FPG)和餐后2h血糖(2hPG)]水平、肾功能指标[血清肌酐(Scr)、尿素氮(BUN),24h尿蛋白],焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果:①干预后,观察组FPG(t=-3.807,P<0.05)、2hPG(t=-3.939,P<0.05)水平均显著低于对照组;②干预后,观察组Scr(t=-2.453,P<0.05)、BUN(t=-3.267,P<0.05)及24h尿蛋白(t=-2.749,P<0.05)水平均低于对照组;③干预后,观察组SAS(t=-5.658,P<0.05)、SDS(t=-3.191,P<0.05)评分均显著低于对照组。结论:饮食指导配合支持性心理干预治疗能有效调节糖尿病肾病腹膜透析患者血糖水平,改善肾功能,有利于心理健康。

Objective:To explore the effects of dietary guidance combined with supportive psychological intervention on blood glucose metabolism,renal function indexes and mental health status in patients with diabetic nephropathy and peritoneal dialysis.Methods:A total of 70 cases of patients with diabetic nephropathy and peritoneal dialysis treated in our hospital from September 2012 to August 2017 were selected and divided into the control group(n=35)and the observation group(n=35)according to the random number table method.The control group was given routine nursing,and the observation group was given dietary guidance combined with supportive psychological intervention on the basis of routine nursing.The levels of blood glucose[fasting plasma glucose(FPG)and postprandial 2 h blood glucose(2 hPG)]and renal function indexes[serum creatinine(Scr),urea nitrogen(BUN),24 h urine protein],and the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were compared between the two groups before and after intervention.Results:After intervention,the levels of FPG and 2 hPG in the observation group were significantly lower than those in the control group(t=-3.807,-3.939;P<0.05).After intervention,the levels of Scr,BUN and 24 h urine protein were lower in the observation group than those in the control group.After intervention,the scores of SAS and SDS in the observation group were significantly lower than those in the control group(t=-2.453,-3.267,-2.749,-5.658,-3.191;P<0.05).Conclusion:Dietary guidance combined with supportive psychological intervention can effectively regulate blood glucose level in patients with diabetic nephropathy and peritoneal dialysis,and improve renal function,and it is conducive to mental health.