腹膜透析患者营养不良的诊治进展  

Progress in the diagnosis and treatment of malnutrition in peritoneal dialysis patients

作　　者：邓倩 汤显湖 王润秀 DENG Qian;TANG Xian-hu;WANG Run-xiu(The First Clinical School of Gannan Medical University;Department of Nephrology,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医科大学第一临床医学院 [2]赣南医科大学第一附属医院肾内科,江西赣州341000

出　　处：《赣南医学院学报》2024年第4期435-440,共6页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：随着腹膜透析(Peritoneal dialysis,PD)技术的成熟,其在终末期肾脏病(End-stage renal disease,ESRD)患者肾脏替代治疗(Renal replacement therapy,RRT)中逐渐流行,但仍难以避免营养不良的发生。营养不良严重影响腹膜透析患者的预后,是腹膜透析患者高住院率及高病死率的主要原因。本文综述了PD患者营养不良的评估方法及治疗相关的研究进展,文献复习结果发现营养不良评估方法主要包括生化指标、人体测量指标、营养评估表等,治疗措施主要包括优化膳食营养摄入、纠正代谢性酸中毒、控制炎症、优化透析方案、保护残余肾功能等。但尚未有国际公认蛋白质-能量消耗(Protein-energy waste,PEW)评分系统被推出,呼吁探索其他敏感特异性指标,并不断设计开发管理策略及找寻干预PEW的最佳管理策略,改善腹膜透析患者预后。With the development and maturation,peritoneal dialysis(PD)has become increasingly popular in renal replacement therapy(RRT)for patients with end-stage renal disease(ESRD).But it is still difficult to avoid the occurrence of malnutrition.Malnutrition seriously affects the prognosis of peritoneal dialysis patients.It is the main reason for the high hospitalization rate and mortality of peritoneal dialysis patients.This paper reviews the evaluation methods of malnutrition in PD patients and the research progress related to its treatment.The literature review results show that the evaluation methods of malnutrition mainly include biochemical indicators,anthropometric indicators,nutrition assessment table,etc.The treatment measures mainly include optimizing dietary nutrient intake,correcting metabolic acidosis,controlling inflammation,optimizing dialysis protocol,protecting residual renal function,etc.To date,no internationally recognized protein-energy waste(PEW)scoring system has been introduced.The aim is to call on researchers to continue to explore other sensitive and specific indicators,and continuously design and develop management strategies and find the best management strategies to intervene in PEW,so as to improve the prognosis of peritoneal dialysis patients.

关 键 词：腹膜透析 营养不良 蛋白质-能量消耗 评估方法 治疗 

分 类 号：R572.2[医药卫生—消化系统]