血液透析治疗过程中胃肠营养补充对患者营养状态的影响  

Effect of gastrointestinal nutritional supplement on malnutrition status in patients with haemodialysis

作　　者：董巧荣[1] 段书众[1] 胡桂才[1] 邢炜[1] 刘俊英[1] 

机构地区：[1]河北省承德医学院附属医院肾内科,067000

出　　处：《临床内科杂志》2013年第11期743-745,共3页Journal of Clinical Internal Medicine

摘　　要：目的 观察血液透析治疗过程中胃肠营养补充对尿毒症患者营养状态的影响.方法 选择病情稳定的维持性血液透析患者54例,均有不同程度的营养不良.将54例患者随机分为研究组和对照组2组,每组各27例.研究组患者每次透析中经胃肠补充高蛋白、高热量营养液250 ml,观察2个月.采用自身对照及组间对照方式,评估两组患者营养状态的变化.结果 治疗后两组患者蛋白质、热量摄入均较治疗前增加（P＜0.01）,但组间比较差异无统计学意义（P＞0.05）;治疗后研究组患者血清白蛋白及握力增加,分别从（35.72±1.47） g/L到（37.34±0.99）g/L（P ＜0.01）、（24.52±3.07）kg到（26.63±3.04） kg（P ＜0.05）,且分别与对照组治疗后（35.92±1.57）g/L、（24.80±2.01）kg比较,差异均有统计学意义（P＜0.01、P＜0.05）.结论 血液透析治疗过程中胃肠营养补充能在短期内显著增加患者血清白蛋白及手握力,改善患者营养不良状况,且该方式经济、方便,患者依从性及耐受性好.Objective To study the effect of gastrointestinal nutritional supplement on malnutri- tion status in uremic patients with haemodialysis. Methods Fifty-four stable patients in different degree of malnutrition with maintenance hemodialysis were recruited. They were randomly divided into the study group（27 cases） and the control group（27 cases）. The study group received 250 ml oral nutritional solu- tion with 18.2 g protein and 429 Kcal calorie during dialysis therapy. All subjects were observed for 2 months. The nutrition status of these patients were evaluated. Results Protein and calorie intake elevated in both groups（ P 〈0.01 ）, but there was no significant difference between two groups（ P 〉 O. 05 ）. After the treatment in the study group, serum albumin and hand grip strength（HGS） increased significantly from （35.72 ~ 1.47）g/L to （37.34 ~0.99）g/L（P 〈0.01）, （24.52 ~3.07）kg to （26.63 ~ 3.04） kg（P 〈 0.05 ）, respectively. Compared with the control group [ （ 35.92 ~ 1.57 ） g/L, （ 24.80 ~ 2.01 ） kg ], differ- ences were significant （ P 〈 0.01, P 〈 0.05, respectively）. Conclusion Gastrointestinal nutritional sup- plement can increase serum albumin and hand grip strength in a short time, and can improve patients＇ nu- tritional state. It is economic, convenient, and has good dependence and tolerance.

关 键 词：透析 胃肠营养 蛋白质 营养不良 

分 类 号：R459.5[医药卫生—治疗学]