饮食干预对白血病患者营养状况和血清白蛋白水平的影响  

Effects of dietary intervention on nutritional status and serum albumin level in leukemia patients

作　　者：金芳芳[1] 徐风敏 张萍[1] 余爱萍[2] Jin Fangfang;Xu Fengmin;Zhang Ping;Yu Aiping(Hematology Department, Ningbo First Hospital, Ningbo 315010, China;Nursing Department, Ningbo First Hospital, Ningbo 315010, Chin)

机构地区：[1]宁波市第一医院血液内科,315010 [2]宁波市第一医院护理部,315010

出　　处：《中华现代护理杂志》2018年第6期656-659,共4页Chinese Journal of Modern Nursing

摘　　要：目的 探讨饮食干预对白血病患者营养状况及血清白蛋白水平的影响,为白血病患者个体化饮食护理提供科学依据.方法 选取2016年5—10月宁波市第一医院收治的80例白血病患者,按随机数字表法分为对照组40例和观察组40例,对照组患者实施血液内科常规护理;观察组患者入院后即用营养风险筛查NRS-2002评估表及患者的实验室生化检查中白蛋白水平进行营养风险评估,评分≥3分作为重点干预对象,〈3分者每周评估,并结合患者化疗前、化疗后1周、化疗后2周的血清白蛋白水平是否处于标准范围内来衡量患者的营养状况,进一步制定有效的饮食干预方案,提高患者对化疗的耐受性.比较干预前后两组患者营养状况及血清白蛋白水平变化.结果 干预前,两组患者营养评估分级情况比较,差异不具有统计学意义（Z=-0.327,P〉0.05）.干预后,观察组评分明显优于干预前,组间比较,观察组明显优于对照组,差异均有统计学意义（Z值分别为-1.986、-2.410;P〈0.05）.观察组化疗后1周和2周的血清白蛋白水平分别为（41.03±2.65）、（43.76±2.82）mg/L,均高于化疗前,差异有统计学意义（P〈0.05）,且均明显高于对照组,差异有统计学意义（P〈0.05）.结论 对白血病患者进行营养筛查和评估,能够早期判断患者存在的营养不良风险,制定针对性的饮食干预可显著改善患者的营养状况,提高患者体内的血清白蛋白水平,对减少化疗后并发症、改善预后有重要意义.Objective To investigate the effects of dietary intervention on nutritional status and serum albumin level of leukemia patients, so as to provide scientific basis for individualized dietary nursing for patients with leukemia. Methods From May to October 2016, a total of 80 leukemia patients in Ningbo First Hospital were divided into control group （n=40） and observation group （n=40） by random number table method. The patients in the control group received routine nursing care. The patients in the observation group were evaluated for nutritional risk on admission with nutritional risk assessment and screening of NRS-2002 and the albumin numerical laboratory of biochemical examination. The patients with scoring more than 3 points were treated as the key intervention objects, while patients with scoring less than 3 points were given weekly assessment. The patients＇ nutritional status was assessed according to whether the serum albumin values of patients before chemotherapy, 1 week after chemotherapy and 2 weeks after chemotherapy were in the standard range. The effective dietary intervention plan was further formulated, in order to improve patients＇ chemotherapy intolerance. The patients＇ nutritional status and serum albumin values of both groups were compared before and after the intervention. Results Before the intervention, there was no statistical difference between the two groups in the comparison of patients nutritional status classification（Z=-0.327,P〉0.05）. After the intervention, the nutritional score in the observation group was significantly better than that before intervention,the difference was statistically significant（Z=-1.986,P〈 0.05）. In the inter-group comparison, the nutritional score of the observation group was significantly better than that of the control group （Z=-2.410,P〈0.05）. In the observation group, the serum albumin level was （41.03±2.65） mg/L at 1 week after chemotherapy, and （43.76±2.82） mg/L at 2 weeks after chemotherapy, which were both signif

关 键 词：白血病 营养状况 血清血蛋白 饮食干预 

分 类 号：R473.73[医药卫生—护理学]