基于PG-SGA的个体化营养干预对血液透析患者营养状态及磷管理效果的影响  

Effect of individualized nutritional intervention based on PG-SGA on nutritional status and phosphorus management in patients undergoing hemodialysis

作　　者：张延萍 何志婷 张倩[1] ZHANG Yan-ping;HE Zhi-ting;ZHANG Qian(Hemodialysis,Baoji Central Hospital,Baoji 721008,Shaanxi,CHINA;Hemodialysis Center,Shaanxi Maternal and Child Health Hospital,Xi'an 710004,Shaanxi,CHINA)

机构地区：[1]宝鸡市中心医院血液透析,陕西宝鸡721008 [2]陕西省妇幼保健院血液透析中心,陕西西安710004

出　　处：《海南医学》2023年第8期1174-1178,共5页Hainan Medical Journal

基　　金：陕西省科学技术研究发展计划项目(编号:2019J16-06-01)。

摘　　要：目的 探究基于患者主观整体评估量表(PG-SGA)的个性化营养干预对血液透析患者营养状态及磷管理效果的影响。方法 回顾性分析2019年6月至2022年1月于宝鸡市中心医院接受血液透析的116例慢性肾衰竭患者资料,其中常规组52例患者接受常规营养干预,观察组64例患者采用基于PG-SGA的个体化营养干预方案。比较两组患者干预前后的营养状态[包括主观综合性营养评估(SGA)、体质量指数(BMI)、血清白蛋白(ALB)、转铁蛋白(SF)和前白蛋白(PA)]、血磷、血钙水平和生活质量评分和自我管理效能评分,以及低血糖发生率。结果 两组患者的性别、年龄、病程、透析时间与疾病类型等资料比较差异均无统计学意义(P>0.05);两组患者干预前的SGA评分、BMI、ALB、SF和PA水平比较差异均无统计学意义(P>0.05),干预后,观察组患者的SGA评分为(9.37±1.60)分,明显低于常规组的(11.12±1.57)分,BMI、ALB、SF和PA水平分别为(22.58±2.14) kg/m^(2)、(40.29±4.94) g/L、(1.69±0.44) g/L和(293.65±31.77) g/L,明显高于常规组的(20.87±2.19) kg/m^(2)、(37.59±4.31) g/L、(1.51±0.38) g/L和(280.74±29.63) g/L,差异均有统计学意义(P<0.05);两组患者干预前的血磷和血钙水平比较差异均无统计学意义(P>0.05),干预后,观察组患者的血磷为(1.69±0.23) mmol/L,明显低于常规组的(1.93±0.27) mmol/L,血钙为(2.46±0.16) mmol/L,明显高于常规组的(2.23±0.14) mmol/L,差异均有统计学意义(P<0.05);两组患者干预前的生活质量评分和自我管理效能评分比较差异均无统计学意义(P>0.05),干预后,观察组患者的生活质量评分和自我管理效能评分分别为(72.39±8.47)分和(38.77±5.21)分,明显高于常规组的(66.45±7.29)分和(34.89±4.36)分,差异均有统计学意义(P<0.05);干预期间,观察组患者的低血糖发生率为3.13%,明显低于常规组的13.46%,差异有统计学意义(P<0.05),但其他不良反应发生率比较差异均无统计Objective To explore the effect of individualized nutritional intervention based on patient-generated subjective global assessment(PG-SGA)on nutritional status and phosphorus management in patients undergoing hemodialysis.Methods The clinical data of 116 patients with chronic renal failure who underwent hemodialysis in Baoji Central Hospital from June 2019 to January 2022 were retrospectively analyzed.Among them,52 patients in the routine group received routine nutritional intervention,and 64 patients in the observation group received individualized nutritional intervention based on PG-SGA.The nutritional status[including subjective comprehensive nutritional assessment(SGA),body mass index(BMI),serum albumin(ALB),transferrin(SF),and prealbumin(PA)],blood phosphorus,serum calcium level,quality of life scores,self-management efficacy scores,and the incidence of hypoglycemia were compared between the two groups before and after intervention.Results There was no significant difference between the two groups in gender,age,course of disease,dialysis time,and disease type(P>0.05).There was no statistically significant difference in SGA score,BMI,ALB,SF,and PA levels between the two groups before intervention(P>0.05).After intervention,the SGA score of the patients in the observation group was(9.37±1.60)points,which was significantly lower than(11.12±1.57)points of the routine group;the levels of BMI,ALB,SF,and PA were(22.58±2.14)kg/m^(2),(40.29±4.94)g/L,(1.69±0.44)g/L,and(293.65±31.77)g/L,which were significantly higher than(20.87±2.19)kg/m^(2),(37.59±4.31)g/L,(1.51±0.38)g/L,and(280.74±29.63)g/L of the routine group;the differences were statistically significant(P<0.05).There was no statistically significant difference in blood phosphorus and blood calcium levels between the two groups before intervention(P>0.05).After intervention,the blood phosphorus level of patients in the observation group was(1.69±0.23)mmol/L,which was significantly lower than(1.93±0.27)mmol/L in the routine group;the blood calcium lev

关 键 词：主观整体评估量表 营养状态 个性化 血液透析 钙磷代谢 

分 类 号：R471[医药卫生—护理学]