系统营养管理干预对慢性肾脏病患者临床转归的影响  

Effect of Nutrition Management Intervention on Clinical Outcome of Chronic Kidney Disease Patients

作　　者：林建荣 高艳[1,2] 王玲 黄婷[2] 余芳 

机构地区：[1]湖北理工学院医学院,湖北黄石435003 [2]湖北省黄石市中心医院营养科,湖北黄石435000

出　　处：《湖北理工学院学报》2018年第1期53-57,共5页Journal of Hubei Polytechnic University

摘　　要：为将慢性肾脏病1~4期患者的GFR下降率控制在最新的国际标准范围之内,延缓慢性肾脏病的发展,选取黄石市中心医院2015年11月至2016年12月收治的慢性肾脏病1~4期门诊患者60例为观察组,将2014年11月至2015年11月收治的慢性肾脏病1~4期门诊患者60例作为对照组。对照组给予传统的营养评估和营养干预;观察组在对照组的基础上,按JCI临床服务项目认证(CCPC)标准,构建多学科成员组成的JCI-CCPC-CKD照护小组,运用系统营养管理法干预。干预1个周期(3个月)后采用t检验对比2组患者的BMI、ALB、HB、LDL-C、GFR和SCr情况。结果表明:(1)干预1个周期后比较2组患者的BMI、ALB、HB、LDL-C,t值分别是3.27,8.214,3.06,2.91,P均<0.01,差异有统计学意义。(2)干预1个周期后比较2组患者的GFR和SCr,t值分别4.48,7.83,P<0.01,差异也存在统计学意义。JCI-CCPC标准下的系统营养管理干预能显著改善患者营养状况,促进肾功能改善。Objective： In order to slow down the rate of GFR in patients with chronic kidney disease（ CKD） 1 ～4 stage,and control the rate under the latest international guidelines. Method： 60 cases of patients in Clinical Care Program Certification（ CCPC）-CKD 1 ～ 4 stage coming to the outpatient in our hospital from November2015 to December 2016 were chosen as the observation group,and 60 cases of outpatient patients in CKD 1 ～4 stage from November 2014 to November 2015 were divided into the control group. The control group was treated with traditional nutritional assessment and nutritional intervention. According to the CCPC standard,a multidisciplinary team of CCPC-CKD care team was constructed,the observation group were using the systemic nutrition management intervention based on the control group. After one cycle period（ three months）,t test was used to compare the BMI,ALB,HB,LDL-C,GFR and SCr between this two groups. Results： After one cycle（ three months） of intervention,there were significant differences in BMI、ALB、HB and LDL-C between the two groups（ t values were 3. 27,8. 214,3. 06 and 2. 91,respectively,all P〈0. 01）,as well as the differences of e GFR and SCr levels between the two groups were statistically significant（ t values were4. 48 and 7. 83,P〈0. 01）. Conclusion： The CCPC standard system nutrition management intervention can significantly improve the nutritional status of CKD patients,and promote the improvement of renal function.

关 键 词：系统营养管理干预 慢性肾脏病 临床转归 

分 类 号：R459.3[医药卫生—治疗学]