多学科营养护理干预对血液透析高磷血症患者控磷饮食依从性、钙磷代谢和营养状况的影响  

Effect of multidisciplinary nutrition nursing intervention on phosphorus control diet compliance,calcium-phosphorus metabolism,and nutritional status of hemodialysis patients with hyperphosphatemia

作　　者：王春玲 谭娟[1] 娄苗 WANG Chunling;TAN Juan;LOU Miao(Blood Purification Center,Wanbei Coal-Electricity Group General Hospital,Suzhou Anhui 234000;Department of Nutrition,Wanbei Coal-Electricity Group General Hospital,Suzhou Anhui 234000,China)

机构地区：[1]皖北煤电集团总医院血液净化中心,安徽宿州234000 [2]皖北煤电集团总医院营养科,安徽宿州234000

出　　处：《临床与病理杂志》2023年第6期1281-1288,共8页Journal of Clinical and Pathological Research

摘　　要：目的:探讨多学科营养护理干预对血液透析高磷血症患者控磷饮食依从性、钙磷代谢和营养状况的影响。方法:选取2019年1月至2021年12月皖北煤电集团总医院血液净化中心接受规律血液透析治疗的92例高磷血症患者。根据透析时间不同,将周一、三、五进行透析的患者分为对照组,周二、四、六患者分为观察组,每组各46例。对照组实施血液透析高磷血症患者常规护理,观察组在常规护理基础上实施多学科营养护理干预。比较2组干预前后控磷饮食依从性、饮食摄入量、钙磷代谢相关指标、钙磷水平达标率及营养状况指标。结果:干预后,观察组饮食相关知识、饮食管理行为及量表总分均显著高于对照组(均P<0.05)。干预后,观察组磷摄入量及磷/蛋白质比显著均低于对照组(均P<0.05),钙及蛋白质摄入量均高于对照组(均P<0.05)。干预后,观察组血磷、全段血清甲状旁腺激素(intact parathyroid hormone,iPTH)水平及钙磷乘积均低于对照组(均P<0.05),血钙水平及血磷、血钙、iPTH水平达标率均明显高于对照组(均P<0.05)。干预后,2组血红蛋白、白蛋白水平差异均无统计学意义(均P>0.05)。结论:多学科营养护理干预能提高血液透析高磷血症患者控磷饮食依从性,有效改善患者钙磷代谢。Objective:To explore the effect of multidisciplinary nutrition nursing intervention on phosphorus control diet compliance,calcium-phosphorus metabolism and nutritional status in hemodialysis patients with hyperphosphatemia.Methods:A total of 92 patients with hyperphosphatemia who received regular hemodialysis treatment in Blood Purification Center of Wanbei Coal-Electricity Group General Hospital from January 2019 to December 2021 were selected as the research subjects.According to different dialysis time,dialysis patients on Monday,Wednesday,and Friday were divided into a control group,and patients on Tuesday,Thursday,and Saturday were divided into an observation group,with 46 cases in each group.The hemodialysis patients with hyperphosphatemia in the control group received routine nursing,and the observation group received multidisciplinary nutritional nursing intervention on the basis of routine nursing.The phosphorus control diet compliance,dietary intake,calcium and phosphorus metabolism-related indexes,calcium and phosphorus level compliance rate and nutritional status indexes of the 2 groups before and after intervention were compared.Results:After intervention,the dietary knowledge,dietary management behavior,and total score of the scale in the observation group were significantly higher than those in the control group(all P<0.05).After intervention,the phosphorus intake and phosphorus/protein ratio in the observation group were significantly lower than those in the control group(all P<0.05),and calcium and protein intake in the observation group were higher than those in the control group(all P<0.05).After intervention,the levels of blood phosphorus,intact parathyroid hormone(iPTH)and calcium-phosphorus product in the observation group were lower than those in the control group(all P<0.05),and the blood calcium level and the compliance rate of blood phosphorus,blood calcium and iPTH in the observation group were significantly higher than those in the control group(all P<0.05).After intervention,the level

关 键 词：多学科营养护理 血液透析 高磷血症 饮食依从性 

分 类 号：R473.5[医药卫生—护理学]