血液灌流串联血液透析改善维持性血液透析合并营养不良患者营养状态的效果及护理(1)
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[摘要] 目的:探讨血液透析(HD)联合血液灌流(HP)治疗维持性血液透析患者营养不良的效果及护理方法。方法:选择2009年1月~2010年8月于本院进行血液透析治疗的患者60例,均血透半年以上,将患者随机分为联合组30例,血透组30例,联合组患者给予血液透析加血液灌流,血透组继续给予血液透析,两组均给予饮食护理指导,治疗半年后观察两组治疗前后营养状态及实验室指标的改变。结果:两组治疗前营养不良发生率差异无统计学意义(60% vs 63.3%,χ2=1.29,P>0.05),治疗后联合组营养不良发生率明显降低,血透组无明显改变,两组比较差异有统计学意义(63.3% vs 26.7%,χ2=16.73,P<0.05),血透组治疗后尿素氮下降,联合组治疗后尿素氮、甲状旁腺素下降,白蛋白、血红蛋白较治疗前升高。结论:血液透析联合血液灌流,在合理的营养护理的基础上可以较好地改善患者的营养状态,提高生活质量,值得应用。
[关键词] 血液透析;血液灌流;营养不良;护理干预
[中图分类号] R459.5 [文献标识码]B[文章编号]1673-7210(2011)07(b)-255-02
Effect and nursing of nutrition status of malnutrition patients treated with hemoperfusion combined hemodialysis
TAN Juan
The First People's Hospital of Loudi City, Hu′nan Province,Loudi 417009, China
[Abstract] Objective: To investigate the effect of nursing of hemodialysis (HD) combined hemoperfusion (HP) treating malnutrition in hemodialysis patients. Methods: 60 hemodialysis patients in our hospital from January 2009 to August 2010 treated with hemodialysis for more than six months were randomly divided into combined group (30 cases) and HD group(30 cases), combined group were treated with HD+HP, HD group continue hemodialysis. Two groups were given dietary guidance, and then to observe the nutritional status and laboratory index changes after six months treatment. Results: The incidence of malnutrition of two groups before treatment was no significant (60% vs 63.3%, χ2=1.29, P>0.05), incidence of malnutrition in combination group a significantly reduced fter treatment no significant change in HD group, difference between two groups was statistically significant (63.3% vs 26.7%, χ2=16.73, P<0.05), BUN of HD group decreased after treatment, and BUN, iPTH decreased, Alb, Hb rose in combined group. Conclusion: HD combined HP can improve nutritional status of HD patient's on the basis of nutritional care, and it is worthy of application.
[Key words] Hemodialysis; Hemoperfusion; Malnutrition; Nursing intervention
血液透析(HD)利用半透膜原理,通过扩散、对流体内各种有害以及多余的代谢废物和过多的电解质移出体外的疗法,是一种较安全、易行、应用广泛的血液净化方法。对许多患者来说维持性血液透析是一种终身替代疗法,但长期血透导致患者大多存在营养不良的现象,影响治疗效果和生存质量。有研究证实不同的透析治疗方法对患者营养状态有不同影响[1] ......
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