体验式营养教育对维持性血液透析患者营养状况的影响
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(1. 宜宾市第二中医院内一科,宜宾 644000;2. 宜宾卫生学校内科教研室,宜宾 644002)

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R47

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Effects of experiential nutrition education on nutritional status among patients with maintenance hemodialysis
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(1. First Department of Internal Medicine, Yibin Second Hospital of Traditional Chinese Medicine, Yibin 644000,China;2. Department of Internal Medicine, Yibin Health School, Yibin 644002, China)

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    摘要:

    目的 研究体验式营养教育是否可改善维持性血液透析(MHD)患者营养状况。方法 入选2017年1月至12月宜宾市第二中医院内一科进行维持性血液透析患者180例,随机数表法分为干预组和对照组,每组90例。分别采取传统和体验式营养教育进行干预,6个月后比较2组患者营养知识-态度-行为(KAP)评分、营养相关生化指标和体格测量指标,并采用患者自评-主观全面评定(PG-SGA)量表评估患者整体营养状况。采用SPSS 19.0统计软件对数据进行分析。结果 2组患者年龄、性别、透析时间、原发疾病等差异无统计学意义(P>0.05)。干预后干预组相比对照组患者知识评分[(8.5±1.3)和(6.7±2.0)分]、行为评分[(4.1±1.0)和(3.4±1.3)分]、血红蛋白[(106.4±9.2)和(96.1±8.7)g/L]、白蛋白[(38.3±5.2)和(36.2±4.9)g/L]、肱三头肌皮褶厚度[(6.1±2.1)和(5.4±1.9)mm]、上臂围[(26.0±4.4)和(24.5±4.1)cm]、上臂肌围[(24.1±2.6)和(22.8±2.9)cm]、体脂比[(22.6±4.1)%和(21.1±4.4)%]水平均高,差异均具有统计学意义(P<0.05)。干预前2组患者PG-SGA评分[(6.1±2.2)和(6.3±2.4)分]差异无统计学意义(P>0.05)。干预后干预组PG-SGA评分低于对照组[(4.5±2.0)和(5.6±2.1)分],差异具有统计学意义(t=3.60, P<0.05)。干预后对照组营养状况A分级 27%(24/90),干预组营养状况A分级40%(36/90),干预组明显高于对照组,差异具有统计学意义(P<0.05)。结论 体验式营养教育可改善MHD患者营养知识、态度和行为,提高患者饮食依从性,改善患者营养状况。

    Abstract:

    Objective To study whether experiential nutrition education can improve nutritional status of maintenance hemodialysis (MHD) patients. Methods From January to December 2017,0 patients undergoing MHD in the First Department of Internal Medicine, Yibin Second Hospital of Traditional Chinese Medicine were recruited, randomly divided into intervention group and control group (n=90 cases in each group), and given experiential and traditional nutrition education respectively. Six months later, nutrition knowledge-attitude-practice (KAP) score, nutrition-related biochemical indicators and physical measurement indicators were compared between the 2 groups. The overall nutritional status of patients was assessed by patient-generated subjective global assessment (PG-SGA) scale. SPSS statistics 19.0 was used for data analysis. Results There were no significant differences in age, gender, dialysis time and primary diseases between the 2 groups (P>0.05). After intervention, the intervention group had obviously higher knowledge score [(8.5±1.3) vs (6.7±2.0)], practice score [(4.1±1.0) vs (3.4±1.3)], hemoglobin level [(106.4±9.2) vs (96.1±8.7)g/L], albumin level [(38.3±5.2) vs(36.2±4.9)g/L], triceps skinfold thickness [(6.1±2.1) vs (5.4±1.9)mm], arm circumference [(26.0±4.4) vs (24.5±4.1)cm], arm muscle circumference [(24.1±2.6) vs (22.8±2.9)cm], and body fat ratio [(22.6±4.1)% vs (21.1±4.4)%] when compared with the control group (all P<0.05). There was no significant difference in PG-SGA score between the 2 groups before intervention [(6.1±2.2) vs(6.3± 2.4), P>0.05]. After intervention, the PG-SGA score was obviously lower in the intervention group than in the control group [(4.5+2.0) vs (5.6+2.1), t=3.60, P<0.05]. The nutritional status A was 27%(24/90) in the control group, and 40%(36/90) in intervention group, with significant difference between them (P<0.05). Conclusion Experiential nutrition education can improve the nutritional knowledge, attitude and practice of MHD patients, promote their dietary compliance and improve their nutritional status.

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兰祥莉,刘婷,车昭军.体验式营养教育对维持性血液透析患者营养状况的影响[J].中华老年多器官疾病杂志,2019,18(9):678~682

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  • 收稿日期:2019-05-09
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  • 在线发布日期: 2019-09-23
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