王盛菲　朱珠　栾伟

摘要：目的  探討微信公众平台在慢性肾脏病（CKD）早期患者饮食健康教育中的应用效果。方法  选择 2017年1月～9月在我科新入院的CKD早期患者108例纳入本次研究，随机分为对照组和实验组，各54例。对照组患者采用传统健康宣教的模式，实验组采用微信公众平台，推送科学健康饮食宣教软文、图画、视频等，供患者浏览学习的健康宣教模式，在出院后第1个月、第3个月、第6个月比较两组饮食依从性及6项营养指标水平。结果  出院后第1个月、第3个月、第6个月实验组钠摄入量、DPI均少于对照组，差异有统计学意义（P<0.05）;出院后第1个月、第3个月、第6个月，实验组BMI及甘油三脂水平比较，差异无统计学意义（P>0.05）;出院后第3个月、第6个月，实验组收缩压、血尿酸水平达标率高于对照组，差异有统计学意义（P<0.05）;出院后第6个月，实验组舒张压、尿蛋白达标率高于对照组，差异有统计学意义（P<0.05）。结论  对CKD早期患者来说，微信公众平台的推广应用，帮助患者了解健康饮食的内容，有效提高患者的饮食依从性，改善生理指标，减轻了临床医护人员的工作负担。

关键词：微信公众平台;CKD早期患者;健康教育

中图分类号：R473.5                                 文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2019.14.062

文章编号：1006-1959（2019）14-0183-04

Abstract：Objective  To explore the application effect of WeChat public platform in diet health education for patients with chronic kidney disease （CKD）.Methods  108 patients with early CKD who were admitted to our department from January to September 2017 were enrolled in this study. They were randomly divided into control group and experimental group， 54 cases each. The patients in the control group adopted the traditional health education mode. The experimental group used the WeChat public platform to push the scientific healthy diet education soft texts， pictures， videos， etc.， for patients to browse the learning health education mode， the first month and the third month after discharge. In the sixth month， the two groups were compared for dietary compliance and 6 nutritional indicators.Results  The sodium intake and DPI of the experimental group in the first month， the third month and the sixth month after discharge were lower than the control group， the difference was statistically significant （P<0.05）;There was no significant difference in BMI and triglyceride levels between the first month， the third month and the sixth month after discharge from the hospital （P>0.05）. The third and sixth months after discharge， The systolic blood pressure and blood uric acid levels in the experimental group were higher than those in the control group，the difference was statistically significant （P<0.05）. In the 6th month after discharge， the experimental group had higher diastolic blood pressure and urine protein compliance rate than the control group，the difference was statistically significant （P<0.05）.Conclusion  For early patients with CKD， the promotion and application of WeChat public platform helps patients understand the content of healthy diet， effectively improve patients' dietary compliance， improve physiological indicators， and reduce the workload of clinical staff.

Key words：WeChat public platform;CKD early patients;Health education

慢性肾脏病（chronic kidney disease，CKD）是各种原发或者继发的肾小球肾炎、肾小管损伤和肾血管的病变的总称，最终会进展为终末期肾病，需要终身治疗，严重威胁着人们的身体健康。研究证明，在慢性肾脏病早期进行有效干预治疗，可有效延缓肾脏功能的损害，提高患者的生活质量和延长患者的生命。健康教育不但包括疾病病因、诱因、诊断和治疗等知识，也包括饮食营养、心理护理等多个方面[1]。饮食营养指导是慢性肾脏病健康教育的重要内容，合理的饮食指导可提高慢性肾脏病患者的饮食依从性，提高患者配合治疗的主动性和对医护人员的信任感。同时饮食干预可改善肾功能相关指标，明显延缓慢性肾脏疾病病情进展[2]。……