行血液透析治疗的肾功能衰竭患儿营养状况调查及其影响因素分析  

Nutritional status and its influence factors of children with renal failure undergoing hemodialysis

作　　者：刘蕾[1] 关浩 季泽俊[1] Liu Lei;Guan Hao;Ji Zejun(Department of Pediatrics,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院儿二科,河南省473000

出　　处：《中国实用医刊》2021年第7期87-90,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析接受血液透析治疗的肾功能衰竭患儿的营养状况及其影响因素,以期指导儿童肾功能衰竭血液透析营养不良的评估与干预。方法回顾性分析2018年6月至2019年6月于南阳医学高等专科学校第一附属医院接受血液透析治疗的60例肾功能衰竭患儿的临床资料,记录其营养不良发生情况[通过中文版儿童营养不良风险评分表(CVPYMS)评估],设计一般资料调查问卷,调查并记录营养不良患儿和营养正常患儿的相关情况,将全部可能的影响因素纳入,经单因素与多因素分析找出行血液透析治疗的肾功能衰竭患儿营养不良的影响因素。结果60例血液透析的肾功能衰竭患儿中,26例CVPYMS评分≥1分,判定为营养不良,营养不良发生率为43.33%(26/60);经单因素并建立Logistic多元回归模型行多因素分析结果显示,透析病程长、透析不充分、促红细胞生成素使用频率低、C反应蛋白(CRP)过表达、焦虑/抑郁为肾功能衰竭患儿血液透析期间发生营养不良的影响因素(OR>1,P<0.05)。结论肾功能衰竭患儿血液透析治疗期间发生营养不良风险高,可能与透析病程长、透析不充分、促红细胞生成素使用频率低、CRP过表达、焦虑/抑郁等因素有关,应对血液透析治疗期间伴有上述营养不良风险因素的肾功能衰竭患儿实施合理干预,以改善其营养状态、提高治疗效果。Objective To analyze the nutritional status and its influence factor of children with renal failure undergoing hemodialysis,and to guide the evaluation and intervention of hemodialysis malnutrition in children with renal failure.Methods The clinical data of 60 children with renal failure who underwent hemodialysis in the First Affiliated Hospital of Nanyang Medical College from June 2018 to June 2019 were retrospectively analyzed.The occurrence of malnutrition,assessed by the Chinese version Pediatric Yorkhill Malnutrition Score(CVPYMS),was recorded.And the general information questionnaire was designed to investigate and record the relevant conditions of children with malnutrition and children with normal nutrition.All possible influencing factors of nutritional status were enrolled in univariate and multivariate analysis,so as to determine the influencing factors of malnutrition in children with renal failure treated by hemodialysis.Results Among the 60 children with renal failure treated by hemodialysis,26 children with CVPYMS score≥1 were judged to be malnourished,the incidence of malnutrition was 43.33%(26/60).The results of univariate and logistic multivariate analysis showed that long course of dialysis,inadequate dialysis,low frequency of erythropoietin use,overexpression of C-reactive protein(CRP),anxiety/depression were the influencing factors of malnutrition during hemodialysis in children with renal failure(OR>1,P<0.05).Conclusions The high risk of malnutrition during hemodialysis treatment in children with renal failure may be related to factors such as long course of dialysis,inadequate dialysis,low frequency of erythropoietin use,CRP overexpression,anxiety/depression.Reasonable interventions should be implemented on children with renal failure who are accompanied by the above-mentioned malnutrition risk factors during hemodialysis treatment,so as to improve the nutritional status and treatment effect.

关 键 词：肾功能衰竭 血液透析 营养状况 影响因素 

分 类 号：R726.9[医药卫生—儿科]