通过肠外营养提高能量供给对维持血液透析患者营养状况的影响  

The value of parenteral nutrition on nutritional status of patients with maintenance hemodialysis

作　　者：梁子安 马春成 禤晓燕 李杰峰 伍劲华 杨爱成 

机构地区：[1]江门市五邑中医院肾内科,广东江门529000

出　　处：《中国处方药》2015年第8期1-3,共3页Journal of China Prescription Drug

基　　金：江门市科技计划项目(2012002)

摘　　要：目的探讨通过肠外营养提高能量供给对维持血液透析患者营养状况的影响。方法按标准纳入2013年1月~2014年9月期间就诊进行维持性血液透析治疗的60例患者,随机分为对照组和试验组,每组患者30例。对照组干预方法：充分透析、积极纠正酸中毒、常规饮食教育、口服营养干预等;试验组干预：除充分透析和积极纠正酸中毒外,每次血液透析过程中给予250 m L 50%葡萄糖注射液,500 m L 8.5%氨基酸注射液和20%中/长链脂肪乳注射液250 m L,记录患者治疗前后的血清白蛋白、血清前蛋白、血清转铁蛋白、蛋白分解率（PCR）、胆固醇、尿素氮、肌酐、C反应蛋白等指标。结果两组患者的胆固醇、尿素氮、肌酐、C反应蛋白等方面治疗前后比较,差异均无统计学意义（P〉0.05）。对照组的血清前蛋白、血清转铁蛋白、PCR经充分透析、积极纠正酸中毒、常规饮食教育和口服营养干预后都稍有提高,但差异无统计学意义（P〉0.05）;而试验组的血清白蛋白、血清前蛋白、血清转铁蛋白、PCR在肠外营养干预后水平均高于干预前,且差异均有统计学意义（P〈0.05）。结论通过肠外营养提高能量供给能够有效地改善维持血液透析患者的营养状况,安全有效。Objective To explore the value of parenteral nutrition on nutritional status of patients with maintenance hemodialysis. Methods Patients are randomly divided into control group and experience group with 300 cases in each group. Control group： adequate dialysis, correction of acidosis, regular diet education, oral nutrition intervention and so on; Experimental group： in addition to the adequate dialysis and correction of acidosis, 250 ml 50% glucose, 500 ml of 8.5% amino acid and 250 ml 20% medium/long-chain fat emulsion was injected to patient in the process of hemodialysis. It is vital to record patients＇ serum albumin, serum preprotein, serum transferrin, standardized protein decomposition rate （PCR）, cholesterol, urea nitrogen, creatinine, c-reactive protein and so on before and after treatment. Results Index of two groups of patients with cholesterol, urea nitrogen, creatinine, and c-reactive protein were no statistically significant difference between before treatment and after treatment （P 〉 0.05） .Compare with after treatment, the clinical index of serum albumin, serum protein and serum transferrin, protein decomposition rate （PCR） of control group had a slightly increase, but no statistical significance （P 〉 0.05） ; However, experimental group had a higher level which had statistical significance （P 〈 0.05）. Conclusion It is safe and effective to improve the nutritional status of maintenance hemodialysis patients through parenteral nutrition.

关 键 词：血液透析 肠外营养 50%葡萄糖 8.5%氨基酸 20%中/长链脂肪乳 

分 类 号：R459.5[医药卫生—治疗学]