【摘要】 目的　了解腹膜透析 (PD)患者营养状况和营养干预措施的效果。　方法　间歇性腹膜透析 (IPD)或连续不卧床腹膜透析 (CAPD)患者 41例 (男 16例 ,女 2 5例 ) ,于接受PD治疗前和出院时分别观察血清肌酐 (Scr)、尿素氮 (BUN)、白蛋白 (Alb)、总蛋白 (TP)、血红蛋白 (Hb)、淋巴细胞计数 (LYM)等营养指示的变化以及营养医嘱变化情况 ,同时记录营养干预情况 ,并分组进行分析。　结果　腹膜透析后Hb升高 ,差异显著 ,TP、Alb均呈下降趋势 ,P >0 .0 5 ;Cr和BUN均有下降 ,有非常显著性差异 (P <0 .0 1) ;患者在腹透期间接受的主要营养干预措施为输注白蛋白、输血、服用维生素C、B6、B1、B2 、叶酸、α D3 以及钙剂和铁剂 ;输注白蛋白对TP和ALb改善不明显 ;输血后Hb升高显著。　结论　CRF病人在开始PD治疗时主要的营养问题是低血红蛋白血症、免疫功能减低和低蛋白血症 ;PD治疗后 ,肾功能和贫血好转 ,低蛋白血症则加重 ,静脉补充白蛋白似乎效果不佳。而EPO、铁剂、维生素C和输血的配合应用对于纠正贫血疗效确切。营养医嘱则能够随PD治疗的开展进行相应的改变。但是 ,接受PD治疗后热量和蛋白质的实际摄入量难以达到营养医嘱要求。更多还原

【Abstract】 Objective In order to realize the nutritional status and therapeutic effect of patients who accepted IPD(intermittent peritoneal dialysis) or CAPD(continuous ambulatory peritoneal dialysis). Methods We summarized 41 cases (male 16 and female 25 among them) with their renal function ,Alb, TP, Hb and lymphocyte count;the nutritional intervention was recorded at the same time;then these data were analysed in groups. Results After PD therapy,Hb and Cr/BUN were significantly improveed,there was no change found in LYM,TP/Alb even went worse than before.Albumin,blood,vitamin C,B 1,B 2,B 6,folic acid and α-D 3 calcium,chalybeate were all used for the nutritional purpose. Conclusion The results of this study indicated that hypohemoglobinemia,hypoproteinemia and hypoimmunity were the main malnutritional issues of patients with CRF;PD(IPD or CAPD)therapy could improve not only renal function but also hypohemia.EPO,chalybeate,vitamin C,folic acid and blood-transfusion were effective.After PD therapy,hypoproteinemia was exacerbated,albumin(10～20g i.v. qod)was inefficient.Dietitian’s advice of shifting from low protein-energy to normal or high protein-energy when patient began PD therapy,could hardly being put into practice.更多还原