【摘要】 目的探讨应用个体化食物成分表的饮食干预对慢性肾脏病(CKD) 3～5期非透析患者血磷及饮食依从性的影响,寻求简便易行的饮食干预方法。方法采用便利抽样法选取2016年3月至2017年3月肾内科住院及定期门诊随访的CKD 3～5期非透析高磷血症患者共70例,采用自身前后对照的方法,比较干预前后患者血磷及相关指标变化情况。结果饮食干预6个月后,CKD 3～5期高磷血症患者的血磷达标率分别为92%、83%和75%,血磷值由(1. 79±0. 20) mmol/L降至(1. 45±0. 26) mmol/L,血浆白蛋白由(36. 85±4. 24) g/L升至(38. 90±2. 80) g/L,全段甲状旁腺激素由(436. 62±213. 62) pg/ml降至(338. 10±210. 04) pg/ml。干预前后比较差异有统计学意义(P <0. 05)。干预后患者饮食依从性及护理满意度均有显著改善(P <0. 05)。结论基于个体化食物成分表的饮食干预可有效降低慢性肾脏病非透析患者血磷水平,提高患者饮食依从性及护理满意度,方法简便,可操作性强。更多还原

【Abstract】 Objective To investigate the effects of dietary intervention by individualized food composition table on serum phosphorus and dietary compliance of patients with chronic kidney disease( CKD) at 3 ～ 5 phases without dialysis,and to explore a simple and convenient method of dietary intervention. Methods A total of 70 patients with CKD at 3 ～ 5 phases without dialysis who were complicated by hyperphosphatemia and hospitalized in department of nephrology of our hospital from March 2016 to March 2017 were enrolled in the study. These patients were selected as subjects according to convenient sampling method. The changes of serum phosphorus and related indexes of patients before and after intervention were observed and compared by means of own control method. Results After 6-month diet intervention,the rates of reaching the standard of serum phosphorous in patients with CKD at 3 ～ 5 phases who were complicated by hyperphosphatemia were 92%,83% and75%,respectively,and the serum levels of phosphorus were decreased from( 1. 79 ± 0. 20) mmol/L to( 1. 45 ± 0. 26) mmol/L,however the levels of plasma-albumin were increased from( 36. 85 ± 4. 24) g/L to( 38. 90 ± 2. 80) g/L,moreover,the parathyroid hormone levels were decreased from( 436. 62 ± 213. 62) pg/ml to( 338. 10 ± 210. 04) pg/ml,there were significant statistically differences in these indexes before intervention and after intervention( P < 0. 05). The dietary compliance of patients and nursing satisfaction degree were significantly improved after intervention( P < 0. 05). Conclusion The dietary intervention based on individual food composition table can effectively reduce the serum levels of phosphorus in patients with CKD without dialysis,and improve the patient’s dietary compliance and nursing satisfaction degree,it is a simple,convenient and feasible method.更多还原