摘要
目的 :评价强化健康教育在持续反复高磷血症血液透析患者中的应用效果。方法 :选择我院血液透析中心2016年1-3月连续3个月反复存在高磷血症血液透析患者29例为研究对象,采用责任护士主导,医生、营养师参与的强化健康教育对患者进行干预,干预时间为3个月,每月对患者的饮食摄入、血磷水平进行评估,并评估干预前后患者的用药情况、营养状况、钙磷代谢知识掌握情况。结果:干预后患者血钙、体质量指数(BMI)、尿素清除指数(Kt/v)、磷结合剂剂量和甲状旁腺激素(i PTH)水平稳定,无明显变化。干预1个月、2个月、3个月时患者血磷的平均值较干预前有明显下降,主观综合营养评估(Subjective Global Assessment,SGA)情况和血白蛋白(ALB)改善(P<0.05)。干预3个月时患者饮食中磷和蛋白质的摄入量较干预前有所下降,饮食的磷蛋白比无明显变化。钙磷代谢知识问卷总得分在干预后得到明显提高。结论 :强化健康教育能够提高持续反复高磷血症血液透析患者钙磷代谢知识水平,降低其血磷水平,在降低患者磷摄入量的同时并不影响营养状况。
Objective： To explore the effects of collaborative intensive education on phosphorous control in hemodialysis （HD） patients with refractory hyperphosphatemia. Methods： Twenty-nine hemodialysis patients having refractory hyperphosphatemia from January to March 2016 were recruited in this study. A collaborative team including nurses, dietitian and physicians was set up to provide intensive education for these patients. After 3-month intervention, the patients＇ nutritional status, serum phosphorous level and mineral metabolism related knowledge were assessed and compared with those at baseline. Results： The patients＇ serum calcium, BMI, Kt/V and iPTH level were stable during the study period; while the serum phosphorous level decreased after the intervention. Both their dietary protein and phosphorous decreased, while their dietary phosphorous/protein ratio did not change. Meanwhile, their nutritional status and mineral metabolism related knowledge improved. Conclusion： The collaborative intensive education could improve the hyperphosphatemia control of HD patients through improving their awareness of mineral bone disorders and lowering dietary phosphorous intake without malnutrition.
作者
朱金荣
门海燕
赵微微
苏春燕
ZHU Jinrong;MEN Haiyan;ZHAO Weiwei;SU Chunyan(Nephrology Department,Peking University Third Hospital,Beijing,100191,China)
出处
《中国护理管理》
CSCD
北大核心
2018年第8期1148-1152,共5页
Chinese Nursing Management
基金
北京大学第三医院护理基金课题(76441-02)
关键词
高磷血症
血液透析
饮食
健康教育
行为改变
hyperphosphatemia
hemodialysis
dietary intake
education
behavior change
