【摘要】 目的探讨低蛋白饮食联合复方α-酮酸治疗维持性血液透析患者钙磷代谢紊乱的效果和护理要点。方法 80例维持性血液透析患者随机分为两组:治疗组(低蛋白饮食联合复方α-酮酸组)和对照组(正常蛋白饮食组),每组40例。记录患者于治疗前、治疗后1、3月的血液透析前测定值:血钙(Ca)、血磷(P)、血钙磷乘积(Ca×P)、血清甲状旁腺激素(iPTH)、血清白蛋白(Alb)和血清前白蛋白(PA)。结果治疗组治疗前血磷为(2.27±0.14)mmol/L,治疗1、3月后分别为(1.81±0.12)mmol/L、(1.79±0.13)mmol/L,与治疗前及对照组比较,差异有统计学意义(P<0.05);治疗3月,治疗组血清iPTH(174.1±71.2)pg/ml较治疗前(411.2±98.3)pg/ml下降(P<0.05)。结论低蛋白饮食联合复方α-酮酸可有效降低血磷、血钙磷乘积和血清iPTH,同时保持患者良好的营养状况。护理人员的精心护理是治疗顺利进行并达到预期目标的重要环节。更多还原

【Abstract】 Objective To investigate the effect of low protein diet supplemented with α-keto acid on the disorder of calcium and phosphorus metabolism in maintenance hemodialysis(MHD)patients,as well as its nursing essence. Methods Eighty MHD patients were randomly divided into two groups: therapy group(low protein diet supplemented with α-keto acid group,40 patients) and control group(normal protein diet group,40 patients).Serum was taken from both groups at the start of the study,after 1 month and 3 months,respectively.The serum levels of calcium(Ca),phosphorus(P),calcium-phosphorus product(Ca×P),intact parathyroid hormone(iPTH),albumin(Alb) and prealbumin(PA) were detected. Results Compared with before the therapy and control group,the serum P at the first and third month after the therapy were(1.81±0.12)mmol/L,(1.79±0.13)mmol/L,decreased than before the therapy were(2.27±0.14)mmol/L,there were significant differences(P<0.05).The serum iPTH at the third month after the therapy was decreased than before the therapy from 411.2±98.3pg/ml to 174.1±71.2pg/ml,there was significant difference(P<0.05). Conclusions Low protein diet supplemented with α-keto acid can decrease the serum levels of P,Ca×P and iPTH effectively and maintain good nutritional state.And close surveillance smooth treatments and achievements of expectations.更多还原