摘要
目的探究粗纤维营养膳食结构对维持性血液透析患者疗效及便秘情况的影响。方法选取在三峡大学第二人民医院进行维持性血液透析的120例患者,根据饮食干预方法不同分为膳食纤维组(n=60)和常规组(n=60)。2组均给予常规饮食干预,膳食纤维组在常规饮食干预的基础上增加食用粗纤维。比较干预前后2组营养指标、肾功能指标和便秘症状评分差异。结果干预后2组血红蛋白、血浆白蛋白和上臂肌围等营养指标均显著改善,且膳食纤维组优于常规组,差异均具有统计学意义(t值分别为4.022、4.272、8.640;P值分别为<0.001,<0.001,<0.001)。干预后2组尿素氮、肌酐、尿酸、尿素清除指数、β2微球蛋白等肾功能指标均显著改善,且膳食纤维组优于常规组,差异均具有统计学意义(t值分别为3.342,4.994,8.590,3.184,4.192;P值分别为0.001,<0.001,<0.001,0.002,<0.001)。干预后2组比较,膳食纤维组患者的排便困难、时间、排便频率、粪便性状、下腹不适及腹胀评分均优于常规组,差异均具有统计学意义(t值分别为6.862,4.477,10.505,4.265,2.559,5.972;P值分别为<0.001,<0.001,<0.001,<0.001,0.012,<0.001)。结论粗纤维营养膳食用于维持性血液透析患者饮食干预可有效改善患者营养状况和便秘症状,提高血液透析效果,值得临床推广。
Objectives To explore the effect of crude fibers in dietary structure on the nutritional status and constipation in patients with long-term hemodialysis.Method A total of 120 patients with long-term hemodialysis treated in the Second People's Hospital of Three Gorges University were divided into dietary fiber group(n=60)and conventional group(n=60),based on their nutritional intervention methods.Conventional diet was taken by the patients in the two groups,and dietary crude fibers were increased on the basis of conventional diet in dietary fiber group.Nutritional index,renal function index and constipation symptom score before and after the intervention were compared between the two groups.Results After the intervention,the nutritional indices of Hb,ALB and circumference of upper arms(AMC)improved in both groups,and the improvement was better in dietary fiber group than in conventional group(t=4.022,4.272 and 8.640 respectively;P<0.001);the renal function indices of BUN,Scr,UA,Kt/V andβ2-MG improved in both groups,and the improvement was also better in dietary fiber group than in conventional group(t=3.342,4.994,8.590,3.184 and 4.192 respectively;P=0.001,<0.001,<0.001,0.002 and<0.001 respectively);the constipation symptom scores of defecation difficulties,time and frequency,the appearance of stools,unpleasant and distention feelings in lower abdomen were better in dietary fiber group than in conventional group(t=6.862,4.477,10.505,4.265,2.559 and 5.972 respectively;P<0.001,<0.001,<0.001,<0.001,0.012 and<0.001 respectively).Conclusion Crude fibers in nutritional diet used for long-term hemodialysis patients can effectively improve their nutritional status and constipation symptoms as well as their hemodialysis efficiency.Therefore,this method is worthy to be promoted clinically.
作者
闫艳
董玉香
YAN Yan;DONG Yu-xiang(Department of Nutriology,The Second People's Hospital of Three Gorges University,Yichang 443000,China;Department of Clinical Nutriology,Xiangyang Central Hospital,Xiangyang 441021,China)
出处
《中国血液净化》
CSCD
2020年第4期217-220,共4页
Chinese Journal of Blood Purification
关键词
血液透析
膳食纤维
饮食干预
肾功能
便秘
Hemodialysis
Dietary fiber
Dietary intervention
Renal function
Constipation
