肾移植患者术后早期营养支持的临床研究

目的探讨肾移植患者术后早期的营养支持治疗及对肾功能的影响。方法对34例肾移植患者术后早期(2周内)的营养支持方法和营养状况进行回顾性分析。根据病人术后2周内实际蛋白摄入量的不同,将34例患者分为A组(摄入蛋白量较高组)和B组(摄入蛋白量较低组),每组各17例。对比两组患者术后2周末的体重、血脂、血清总蛋白、白蛋白、球蛋白、肾功能的变化情况以及切口愈合情况的关系。结果A组总蛋白质的含量明显高于B组(P<0.05);A组白蛋白、球蛋白、血红蛋白含量略高于B组,但两组间均无显著差异(P>0.05);两组血脂术后A组除载脂蛋白A1显著高于B组外(P<0.05),其他指标差异不显著;B组肌酐值较A组显著降低(P<0.05),尿素氮和尿酸的变化差异不明显(P>0.05)。结论肾移植患者术后早期给予合理的优质蛋白,对切口愈合、机体总蛋白合成及改善机体营养状况都有很大的促进作用,但肾移植术后早期仍应控制氮的摄入量,以尽量减轻移植肾的负担,保护移植肾的功能。

Clinical investigation of early postoperative nutritional support in renal transplantation

Objective To study the early postoperative nutritional support in the renal transplantation and its effects on renal function.Methods The early nutritional support and nutritional status were analyzed retrospectively in 34 cases who received the operation of renal transplantation.The patients were divided into group A(17 patients,high amount of protein intake) and group B(17 patients,low amount of protein intake) according to the different amount of actual nutritional intake during the period of two weeks after renal transplantation.The changes of body weight,blood fat,total serum protein,albumin,globulin,renal function recovery and wound healing state were evaluated between two groups of two weeks after renal transplantation.Results The total protein content of group A was better than that of group B(P<0.05);The level of serum albumin,globulin and hemoglobin of group A was higher than that of group B,but there was no significant difference between the two groups(P>0.05);The level of apolipoprotein-A1 of group A was higher than that of group B(P<0.05);The creatinine level of group B was lower than group A(P<0.05),but there was no significant difference in urea nitrogen and uric acid between the two groups(P>0.05).Conclusion Offering rational high-quality protein in early stage after renal transplantation is good for wound healing,total protein synthesis and the nutritional status improvement of patients.And the amount of nitrogen intake should be controlled in early postoperative renal transplantation.