摘要
目的对维持血液透析患者营养不良发生的影响因素进行分析,并探讨有效合理的护理对策。方法回顾性分析2018年6月-2019年6月入住本院血液透析室进行维持血液透析治疗的118例患者的临床资料,使用改良定量主观整体评估表(MQSGA)对比各组患者的相关生化指标,对透析患者的营养状况进行综合评估,然后将患者分为轻中度营养不良组、重度营养不良组及正常组,收集可能造成维持血液透析患者营养不良的相关因素,进行二分类logistic回归分析,并探讨相关护理对策。结果由改良定量主观整体评估表显示,轻中度营养不良组58例,重度营养不良组8例,营养不良患者共66例,发生率为55.9%,营养正常者52例;在营养状况不同的患者间两两比较Cr、Alb、PA差异均有统计学意义(P<0.05);单因素分析显示:维持血液透析患者营养不良的发生与透析时间、年龄、PA、Cr、Alb、hs-CRP、Kt/V值、合并糖尿病及高血压等因素有关(P<0.05);Logistic回归分析显示,透析时间≥3年、年龄≥60岁、血清超敏C反应蛋白≥3mg/L、尿素清除指数<1.20是维持血液透析患者营养不良发生的危险因素(OR=1.502、1.732、1.186、2.042,P<0.05)。结论回维持血液透析患者营养不良发生率较大,透析时间长、年龄大、尿素清除指数低及超敏C反应蛋白水平高是评价营养不良的可靠指标,对于维持血液透析患者营养不良的情况,注意相关危险因素,针对性地采取护理措施,可在一定程度上改善患者的营养状况和生活质量。
Objective To scientifically analyze the influencing factors of malnutrition in hemodialysis patients,and explore the effective and reasonable nursing countermeasures.Methods A retrospective analysis in June 2018 to June 2019 in our hospital hemodialysis room for maintenance hemodialysis treatment of the clinical data of 118 patients,using quantitative subjective improvement of the overall assessment(MQSGA)compared to groups of patients related biochemical indicators,comprehensive evaluation of the nutritional status of dialysis patients,and then divided the patients into mild-to-moderate malnutrition,severe malnutrition group and normal group,collection may result in maintenance hemodialysis patients with malnutrition,related factors,classification and logistic regression analysis,and discusses the related nursing countermeasure.Results According to the modified quantitative subjective overall assessment table,there were 58 cases in the mild to moderate malnutrition group and 8cases in the severe malnutrition group.There were 66 cases of malnutrition patients,with an incidence of 55.9%and 52 cases with normal nutrition.There were statistically significant differences in Cr,Alb and PA between patients with different nutritional status(P<0.05).Univariate analysis showed that the incidence of malnutrition in patients with maintenance hemodialysis was related to dialysis time,age,PA,Cr,Alb,HS-CRP,Kt/V value,combined with diabetes and hypertension(P<0.05).Logistic regression analysis showed that dialysis duration≥3 years,age≥60 years,serum hypersensitive C-reactive protein≥3 mg/L,and urea clearance index<1.20 were risk factors for malnutrition in maintenance hemodialysis patients(OR=1.502,1.732,1.186,2.042,P<0.05).Conclusion The incidence of maintenance hemodialysis patients with malnutrition is bigger,long dialysis time,age,urea clearance index is low,and the evaluation of the hypersensitive c-reactive protein level high is a reliable indicator for malnutrition,in the case of maintenance hemodialysis patients with malnutrition,pay attention to the related risk factors,targeted nursing measures,can to a certain extent,improve the nutritional status and quality of life of patients.
作者
韩静
HAN Jing(The Third People's Hospital of Zhengzhou,Zhengzhou 450000,China)
出处
《新疆医学》
2022年第8期977-979,994,共4页
Xinjiang Medical Journal
关键词
维持血液透析
营养不良
终末期肾病
影响因素
护理对策
maintenance hemodialysis
malnutrition
end-stage renal disease
influencing factors
nursing countermeasures
作者简介
韩静,女,护理师,研究方向:血液净化。
