血液透析与腹膜透析对尿毒症患者营养状况的比较分析

2016-08-30丘美蓉梁玉枫陈勇平

中国卫生标准管理 2016年13期

丘美蓉梁玉枫陈勇平

丘美蓉梁玉枫陈勇平

目的通过对尿毒症患者替代治疗下的营养状态的研究，分析不同透析方式对尿毒症患者营养状况的影响。方法选取维持性血液透析（HD）患者44例（血透组），连续不卧床腹膜透析（CAPD）患者42例（腹透组），透析时间均≥12个月。对维持性透析替代治疗12个月以上的尿毒症患者，记录其年龄、性别、原发病、透析龄等数据，同时结合主观综合性营养评估法（SGA）分析2组患者的营养状况，利用统计软件对相关数据进行比对。结果 2组患者在年龄、性别、透析时间及原发病疾病的构成方面差异均无统计学意义（P＞0.05），两组在Alb、PAlb、TG、CHOL、HGS、MAMC、SGA等方面比较差异有统计学意义（P＜0.05）。2组患者在Hb、hs-CRP、BMI差异均无统计学意义（P＞0.05）。结论对长期透析替代治疗的患者研究发现，血透患者营养状况优于腹透患者。并且，腹透组患者脂代谢紊乱较血透组严重。

血液透析；腹膜透析；营养状况；营养不良

doi：10.3969/j.issn.1674-9316.2016.13.050

【Abstract】

Objective To compare the effect of hemodialysis and peritoneal dialysis to nutritional status of patients with uremia. Methods 44 patients in maintenance hemodialysis（HD）group and 42 patients in discontinuous ambulatory peritoneal dialysis（CAPD）group were investigated，all patients were on dialysis for more than one years. We collected the clinical characteristics on age，gender，primary disease，duration of dialysis，and so on，combination with subjective global assessment（SGA）to analyze the nutrition status of two group patients . We compared clinical information on the usage of statistical software. Results There were no significant difference in age，gender，primary disease between the two groups（P＞0.05）. The two groups showed significant difference in Alb，PAlb，TG，CHOL，HGS，MAMC，SGA（P＜ 0.05），however，there were not significant difference in Hb，hs-CRP，BMI（P＞0.05）. Conclusion We access the nutritional status of patients with ESRD who were suffered maintenance dialysis，and found that the hemodialysis have a better nutritional status compared to peritoneal dialysis，otherwise，patients in peritoneal dialysis could face more severe situation with dysregulation of lipid metabolism.

【Key words】Hemodialysis，Peritoneal dialysis，Nutritional status，Malnutrition

目前肾脏替代治疗的方案主要是血液透析和腹膜透析，不同透析方式下患者生存质量的研究表明，血液透析与腹膜透析的患者的生存质量无差异。但是随着透析时间的延长，不同替代治疗患者的营养状况逐渐不同［1］。本文通过回顾性分析我科维持性血液透析和腹膜透析治疗超过1年的84例尿毒症患者，旨在了解两种不同替代治疗方法对患者的营养状态的影响，并分析可能的影响因素。