摘要
目的探讨医学营养治疗和膳食护理干预对老年糖尿病肾病(DN)早期患者临床结局的影响。方法选取本院2013年10月至2018年4月收治的老年DN患者48例,入院当天实施营养风险筛查后,随机分为对照组和观察组,各24例。对照组男16例,女8例,年龄范围60~86岁,年龄(70.24±8.55)岁,糖尿病病程(9.78±5.31)年。观察组男15例,女9例,年龄范围61~87岁,年龄(69.38±9.02)岁,糖尿病病程(10.12±8.69)年。对照组给予常规药物和营养治疗以及饮食护理指导,观察组根据营养代谢状况给予医学营养治疗和膳食护理干预指导。干预6个月后复诊,统计比较两组营养状况、肾脏功能等指标。结果干预前和干预后,两组体质量指数(BMI)、糖化血红蛋白、24 h尿蛋白及血肌酐水平比较,差异均无统计学意义(均P>0.05),且干预前两组血清白蛋白水平差异亦无统计学意义(P>0.05)。在干预后,两组血清白蛋白水平差异有统计学意义(P<0.05)。两组干预后营养风险筛查结果比较,差异有统计学意义,观察组有8例恢复正常营养,而对照组仅4例恢复正常营养状态(P<0.05)。结论医学营养治疗和膳食护理干预指导可保证老年DN患者优质蛋白摄入量,在保证机体基本蛋白需求和减轻肾脏负担的情况下,有效改善患者营养状况,延缓和控制患者病情的进展。
Objective To investigate the effect of medical nutrition therapy and dietary nursing intervention on clinical outcomes in patients with early-onset diabetic nephropathy(DN).Methods Forty-eight elderly patients with DN were enrolled in our hospital.After screening for nutritional risk on the day of admission,the patients were randomly divided into a control group and an observation group,24 cases for each group.There were 16 male and 8 female in the control group;they were 60-86 years old,with an average of(70.24±8.55)years and a diabetic course of(9.78±5.31)years.There were 15 male and 9 female in the observation group;they were 61-87 years old,with an average of(69.38±9.02)years and a diabetic course of(10.12±8.69)years.The control group received routine medication,nutritional therapy,and dietary care guidance.The observation group was given medical nutritional therapy and dietary care intervention guidance according to the patients’nutritional metabolism.The patients were followed up for 6 months;and the nutritional status and renal function of the two groups were compared.Results Before the intervention,there were no statistical differences in body mass index(BMI),glycosylated hemoglobin,serum albumin,24 h urine protein,and serum creatinine between the two groups(all P>0.05).After the intervention,there were no statistical differences in BMI,glycosylated hemoglobin,24 h urine protein,and serum creatinine between the two groups(all P>0.05).After the intervention,the serum albumin level of the observation group increased more than that of the control group(P<0.05).There were statistical differences in nutritional risk screening results between the two groups(P<0.05).Conclusion Medical nutrition therapy and dietary nursing intervention guidance can ensure the quality protein intake of elderly patients with DN,effectively improve their nutritional status,delay and control the progress of their conditions while ensuring the basic protein requirements of the body and reducing their kidney burden.
作者
汤锦美
胡登科
Tang Jinmei;Hu Dengke(Department of Nephrology,Lianyungang Fourth People's Hospital,Lianyungang 222000,China)
出处
《国际医药卫生导报》
2020年第6期769-772,共4页
International Medicine and Health Guidance News
基金
南京医科大学康达科研基金项目(NY KDKJ 2015034)
连云港市卫生计生科技项目(201626)。
关键词
营养治疗
膳食护理
老年DN
营养状况
肾脏功能
转归
Nutritional therapy
Dietary care
Senile DN
Nutritional status
Renal function
Outcomes
