量化管理对慢性肾脏病患者饮食依从性的影响

目的：探讨应用量化管理提高慢性肾脏病（CKD）患者饮食依从性的效果，为临床护理工作提供理论依据。方法：运用专案改善方法分析原因，制订量化管理及健康教育标准化方案，选取2016年10月我院肾内科CKD管理中心规律随访≥3个月的100例CKD3～4期患者，随机分为两组，对照组予以口头教育随访结合材料发放干预，观察组予以量化饮食管理干预。结果：干预6个月后，对照组患者每日钠盐摄入量为（6.18±0.95） g，较前无改变（P＞0.05），每日蛋白质摄入量（DPI）达到（1.33±0.23）g，尽管显著减少（P＜0.001），但均值水平仍显著高于推荐值；观察组患者每日钠盐摄入量为（3.10±0.87）g/d及DPI为（0.77±0.13） g/24 h均显著减少（P＜0.001），已较接近推荐值(分别为2.4g、0.6 g/24 h)，两组比较差异具有统计学意义（P＜0.001）。结论：量化管理可有效降低肾病患者每日钠盐和蛋白质摄入量，提高患者饮食依从性。

Quantitative management on the dietary adherence of patients with chronic kidney disease

Objective: To explore the effect of using quantitative management to improve the dietary adherence of patients with chronic kidney disease, and to provide theoretical basis for clinical nursing work. Methods: After analyzed the reason by the project improvement methods, we made the quantitative management and standardization of health education plan. 100 cases of CKD 3~4 were selected from the kidney department of the renal internal medicine CKD in October 2016, randomly divided into two groups. The patients of control group were given oral education combined with material distribution intervention, while the patients of observation group were given quantified diet management intervention. Results: After 6 months intervention, in the control group patients, the daily sodium intake(DSI) was（6.18±0.95）g (P＞0.05), daily protein intake(DPI) was（1.33±0.23）g (P＜0.001), Although there was a significant decline after intervention, but still was higher than recommended daily allowance. The DSI in the observation group patients was（3.10±0.87）g and DPI was（0.77±0.13）g. There were significantly reduced (P＜0.001), and it had been relatively close to the recommended value (DSI 2.4g and DPI 0.6g), there was a statistical difference between the two groups (P＜0.001).Conclusion: Quantitative management can effectively reduce DSI and DPI in the kidney patients, improve dietary adherence.