甲状旁腺切除术对维持性血液透析病人营养改善的影响  

Influence of parathyroidectomy on nutrition improvement of maintenance hemodialysis patients

作　　者：彭银燕[1] 宋利[1] 符霞[1] 

机构地区：[1]广东省医学科学院广东省人民医院

出　　处：《护理研究（下旬版）》2015年第7期2573-2575,共3页Chinese Nursing Researsh

基　　金：广东省医学科学技术研究基金项目;编号:B2012013

摘　　要：[目的]探讨甲状旁腺全切加前臂自体移植术(tPTX+AT)对维持性血液透析病人营养改善的影响。[方法]选择2012年7月—2013年12月我院接受tPTX+AT的维持性血液透析病人30例,分析病人术前、术后1d、术后7d和术后30d血清白蛋白、血清钙、血清磷、血清碱性磷酸酶、钙磷乘积、血清甲状旁腺激素变化及术前和术后30d病人骨痛和全身瘙痒的情况。[结果]甲状旁腺切除术病人术后1d血清白蛋白明显下降,随后逐渐升高;术后30d血清白蛋白、血清钙、血清磷、钙磷乘积、血清甲状旁腺激素、血清碱性磷酸酶、骨痛和全身瘙痒较术前均明显改善(P<0.05)。[结论]甲状旁腺切除术不仅能降低继发甲状旁腺功能亢进维持性血液透析病人甲状旁腺激素、血清磷,还能明显改善病人营养状况,缓解骨痛、瘙痒等常见并发症。Objective:To probe into the influence of parathyroid hysterectomy and forearm autograft(tPTX+AT)on nutrition improvement of maintenance hemodialysis(MHD)patients.Methods:A total of 30 cases of patients with MDH receiving tPTX+AT from July 2012 to December 2013 were selected,then to analyze the changes of serum albumin,serum calcium and serum phosphorus,serum alkaline phosphatase,calcium-phosphorus product,serum parathyroid hormone before operation and on the 1st day,7th day and 30 th day after operation,and status of bone pain and body itching in patients before operation and on the postoperative 30 th day.Results:Serum albumin significantly decreased on the postoperative 1st day,then gradually increased in parathyroidectomy patients;serum albumin,serum calcium,serum phosphorus and the calcium-phosphorus product,serum parathyroid hormone,serum alkaline phosphatase,bone pain and body itching were significantly improved on the postoperative 30 th day(P<0.05).Conclusion:Parathyroidectomy not only can reduce parathyroid hormone and serum phosphorus in maintenance hemodialysis patients with severe secondary hyperparathyroidism,but also can obviously improve the nutritional status of patients,reduce the common complications such as bone pain and pruritus.

关 键 词：维持性血液透析 甲状旁腺切除术 继发性甲状旁腺功能亢进 营养 

分 类 号：R473.6[医药卫生—护理学]