基于网络平台的营养干预对维持性血液透析患者营养状况的影响  

Effect of individualized nutrition management intervention based on web platforms on the nutritional status and calcium⁃phosphate metabolism disor⁃der in patients undergoing maintenance hemodialysis

作　　者：李海棠[1] 张丽娟 徐慧 LI Hai⁃tang;ZHANG Li⁃juan;XU Hui(Blood Purification Center,Rugao Hospital of Traditional Chinese Medicine,Nantong 226500,China)

机构地区：[1]如皋市中医院血液净化中心,江苏南通226500

出　　处：《哈尔滨医科大学学报》2024年第5期557-562,共6页Journal of Harbin Medical University

基　　金：江苏省自然科学基金面上项目(BK20201235)

摘　　要：目的 旨在探讨基于网络平台的个体化营养管理干预对维持性血液透析患者营养状况及钙磷代谢紊乱的影响。方法 选取2023年3月~10月于如皋市中医院进行血液透析的患者80例,根据随机数字表法分为常规组(40例)与干预组(40例),常规组患者接受常规饮食管理干预,干预组患者接受基于网络平台的个体化营养管理干预。两组患者均接受干预6个月,比较两组患者T0(干预前)、T1(干预3个月)、T2(干预6个月)后饮食管理依从性、营养学指标(血清总蛋白、白蛋白、前白蛋白水平)、血磷、血钙水平与营养状况。结果 与T0时比较,两组患者T1、T2时液体限制、摄钾管理、自我护理、摄盐管理、面对困难五项评分均升高,且干预组五项评分均高于常规组(P_(组间)、P_(时间)、P_(交互)<0.05)。两组患者在T1、T2时血清总蛋白(total protein, TP)、白蛋白(albumin, Alb)、前白蛋白(prealbumin, PA)均升高,且干预组高于常规组。与T0时比较,T1、T2时干预组与常规组患者血磷与血钙水平均降低(P_(组间)、P_(时间)、P_(交互)<0.05)。两组患者在T1、T2时营养不良患者例数减少,且干预组患者营养不良例数少于常规组(P<0.05)。结论 基于网络平台的个体化营养管理干预可作为维持性血液透析患者营养管理的有效方法,有助于提高患者的生活质量和治疗效果。Objective To explore the effect of individualized nutrition management intervention based on web platforms on the nutritional status and calcium⁃phosphate metabolism disorder in patients undergoing maintenance hemodialysis.Methods Eighty patients undergoing hemodi⁃alysis at Rugao Hospital of Traditional Chinese Medicine from March to October 2023 were se⁃lected and randomly divided into conventional group(40 patients)and intervention group(40 patients)using a random number table method.The conventional group received standard diet⁃ary management intervention,while the intervention group received personalized nutritional management through a web⁃based platform.Both groups underwent interventions for six months.The dietary compliance,nutritional indices(serum total protein(TP),albumin(Alb),and prealbumin(PA)levels),serum phosphorus,calcium levels,and nutritional sta⁃tus were compared at baseline(T0),three months(T1),and six months(T2)after the inter⁃vention.Results Compared with T0,scores for fluid restriction,potassium management,self⁃care,sodium intake management,and facing difficulties significantly increased at T1 and T2 in both groups,with the intervention group scoring higher than the conventional group(P_(group),P_(time),P_(interaction)<0.05).Serum TP,Alb,and PA levels increased at T1 and T2 in both groups,with higher levels observed in the intervention group.Compared with T0,blood phos⁃phate and calcium levels decreased at T1 and T2 in both the intervention and conventional groups(P_(group),P_(time),P_(interaction)<0.05).The number of patients with malnutrition decreased at T1 and T2 in both groups,with fewer malnutrition cases in the intervention group(P<0.05).Conclusion Individualized nutrition management intervention based on web platforms can serve as an effective method for nutritional management in patients undergoing maintenance he⁃modialysis,contributing to improved quality of life and treatment outcomes.

关 键 词：网络平台 个体化营养管理干预 维持性血液透析 营养状况 钙磷代谢紊乱 

分 类 号：R459.5[医药卫生—治疗学]