膳食管理(饮食治疗)对持续不卧床腹膜透析患者的营养状态及透析充分性的影响

目的　通过膳食管理 (饮食治疗 ) ,观察持续不卧床腹膜透析 (CAPD)的营养状态及透析充分性的影响。方法　 17例CAPD患者采取制定饮食标准 ,强化饮食治疗 6个月 ,营养指标及透析充分性每月随访检查 1次。结果　 (1)饮食治疗后患者体重增加 ,精神改善 ,乏力感减轻 ;(2 )主观综合性营养评估 (SGA)可见营养不良患者明显减少 (P <0 0 5 ) ,无重度营养不良 ;(3)饮食治疗后血浆总蛋白、前白蛋白、转铁蛋白、白蛋白、血红蛋白、红细胞压积、甘油三酯及血尿素氮均明显提高 (P <0 0 5 ) ,标准蛋白分解率 (nRCP)增加 (P <0 0 5 ) ;(4 )KT/V明显增加 (P <0 0 5 )。结论　合理膳食是CAPD患者的重要治疗手段 ,能改善CAPD效果 ,减少营养不良发生率 ,提高腹膜透析充分性。

The influence of dietary management on nutritional status and dialysis adequacy in continuous ambulatory peritoneal dialysis (CAPD) patients

Objective To investigate the influence of dietary management on nutritional status and dialysis adequacy in CAPD patients.Methods 17 CAPD patients followed up to six months(aged 18 to 73yr) were advised to follow standard nutritional diet.The nutritional indexes and dialysis effects were detirmined every month.Results After dietary management:(1)the increase of body weight and the improvement of weekness were found;(2)The Subjective Global Assessment (SGA) showed a significant improvement in the nutritional status(P<0.05) without the severe malnutrition;(3)there were the significantly(P<0.05) increase levels of serum total protein,preciding albumin,transfer iron albumin,serum albumin,temoglobin,HCT,serum triglyceride,serum cholesterol,Blood Urea and normalized protein catabolic rate (nPCR);(4)and there was a significant increase levels of fractional urea clearance(KT/V).Conclusions Nutritional management can improve nutritional status and dialysis adequacy in CAPD patients.